How can the success of a glaucoma operation be predicted?

PURPOSE: The effect of glaucoma surgery can simply be measured in terms of intraocular pressure (IOP) reduction. However, IOP reduction is not the final goal of glaucoma surgery, but rather long-term visual field preservation. Visual field preservation, on the other hand, can only be judged many years after surgery. Therefore, a formula that could be used to define the success of a pressure-lowering operation soon after surgery should take account of IOP reduction, but the correlation between "successful IOP reduction" and "long-term visual field preservation" should be as high as possible. METHODS: In an attempt to find such a formula, we examined the long-term course with reference to both IOP and visual field in 108 patients (mean follow-up 7.9 years). Several criteria were tested for their ability to predict the long-term visual field preservation. RESULT: The best correlation was obtained by a combined criterion specifying both an absolute upper limit and a relative IOP decrease (i.e. IOP postoperatively < 0.8*IOP preoperatively and IOP postoperatively < 21 mmHg). CONCLUSION: We recommend use of this criterion whenever the effect of a pressure-lowering operation has to be estimated shortly after surgery.     

Are there social correlates to suicide?

A structural-sociological approach to suicide research holds that an aggregate-level cause of suicide should correlate with the suicide rates in a population. In 1980, Sainsbury, Jenkins, and Levey published the article "The Social Correlates of Suicide in Europe" which related the suicide rates in 1961-63 and the changes in them in the following 11 years to 15 social variables in 18 European countries. Its main findings were that the changes in suicide rates could be attributed to specific changes in the social environment. Complementary discriminant analyses showed that it was possible accurately to divide the countries into low- and high-change suicide rate groups on the basis of a combination of the social variables. Although criticized for its method, the study has been widely quoted and sometimes presented as the most definitive current study on the subject. In order to see whether its results held for similar data 16 years later it was replicated for 1977-79 and the ensuing 11 years, with data and method as similar as possible to the original. The results agreed with those of the original study on only one point: the correlations between the levels of the social variables and those of the suicide rates were similar in both periods. However, changes in the suicide rates were unrelated to either the levels of the social variables or the changes in them: correlations found in the original study tended to change profoundly or disappear. Moreover, the results of the original discriminant analyses were a property of the method employed and thus independent of the data. Statistical artefacts or social processes such as changing expectations are unlikely to explain the suddenly changing or vanishing correlations. The original correlations seem to have been largely spurious and dependent on the fact that the more modern countries in Europe experienced a "suicide boom" in the 1960s. As the boom waned in these, it was beginning in the less modern countries: the correlations between the processes indicated by the social variables and the suicide rates were reversed or disappeared. The results call the existence of clear relations between these "suicidogenic" social circumstances and the suicide rates into question. Since many of the variables used are traditional "Durkheimian" indicators of the integration of society, a critique of this still-dominant view of the relationship between society and suicide mortality, or its common operationalization, is implied.     

Freud’s debt to stoicism? A critical response to Kirsner.

In “Freud, Civilization, Religion, and Stoicism” Douglas Kirsner (2006a) writes of the neglect in the psychoanalytical literature of mention of “Freud’s debt to stoicism”. His essay, he adds, is an attempt to “develop the idea of Freud as a stoic still further”. What does it mean to say that Freud is, at least to some degree, a Stoic and that he owes a debt to them? If a debt exists, it exists because there are numerous striking similarities that show a direct or significant influence of the Stoics on Freud. In this commentary, I show that the similarities Kirsner notes are indirect and, most importantly, insignificant. Freud is not in any meaningful sense a Stoic and, thus, he owes no debt to them. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Pallidal stimulation: an alternative to pallidotomy?

A resurgence of interest in the surgical treatment of Parkinson's disease (PD) came with the rediscovery of posteroventral pallidotomy by Laitinen in 1985. Laitinen's procedure improved most symptoms in drug-resistant PD, which engendered wide interest in the neurosurgical community. Another lesioning procedure, ventrolateral thalamotomy, has become a powerful alternative to stimulate the nucleus ventralis intermedius, producing high long-term success rates and low morbidity rates. Pallidal stimulation has not met with the same success. According to the literature pallidotomy improves the "on" symptoms of PD, such as dyskinesias, as well as the "off" symptoms, such as rigidity, bradykinesia, and on-off fluctuations. Pallidal stimulation improves bradykinesia and rigidity to a minor extent; however, its strength seems to be in improving levodopa-induced dyskinesias. Stimulation often produces an improvement in the hyper- or dyskinetic upper limbs, but increases the "freezing" phenomenon in the lower limbs at the same time. Considering the small increase in the patient's independence, the high costs of bilateral implants, and the difficulty most patients experience in handling the devices, the question arises as to whether bilateral pallidal stimulation is a real alternative to pallidotomy.     

Whatever happened to neurosis? An overview.

Discusses the decision to eliminate the term "neurosis" from the DSM-III. The history of the term is traced; weaknesses of DSM-II pertaining to neurosis are presented; theoretical and political processes in the deletion procedure are described; and an overview is given of the current resolution as presented in DSM-III. Instead of neurosis, "neurotic disorder" and "neurotic process" were distinguished to reduce potential theoretical bias. The process may or may not be seen by the clinician as causal in the disorder, but those of all theoretical persuasions should be able to agree on what the disorder is. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Solution to the Mental Health Problem?

Discusses other solutions to the mental health problem other than increasing the number of psychologists, psychiatrists, and social workers. At the author's state supported adult outpatient clinic, they have modified the operation of their clinic to make an approach to this problem by utilizing a resource group of those who are already in a position to foster the psychological health of others, such as ministers, physicians, and teachers. The authors discuss the implementation of this philosophy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is interest maturity related to linguistic development?

A group (Group A) of 119 college freshmen whose quantitative (Q) scores on the ACE Psychological Examination were 20 or more points higher than their language (L) scores, were compared with a group (Group B) of 110 students (equated with Group A on Q scores) whose Q and L scores did not differ by more than 4 percentile points. Strong VIB scores for 6 occupational scales and for 3 non-occupational scales were compared for the 2 groups. The Group B, with equal Q and L scores, scored significantly higher than Group A on the Interest Maturity VIB scale. No other differences were significant. "In view of the findings… , IM appears to be related to a balance in development between verbal and quantitative abilities." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What ought psychology to do?

The Reverend Jesse Jackson addressed the American Psychological Association on August 20, 1999, in Boston, Massachusetts. His speech concerned social justice and psychology. This article presents the text of an abridged version of his remarks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is differential item difficulty specific to hypnosis?

Previous hypnosis studies obtaining retrospective depth reports (e.g., Perry & Laurence, 1980) or retrospective realness reports (e.g., Page & Handley, 1992) have found a "parallel nonoverlapping" pattern between mean depth or realness and susceptibility scale items for high- through low-susceptible subjects. To determine if such a pattern, as well as differential item difficulty in general, is specific to hypnosis, 98 undergraduates were administered the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) of Shor and Orne (1962) as a "test of visual and motor imagination," omitting the eye-closure induction (item #2). A pattern similar to other studies that employed hypnosis was produced. While supporting attribution theory (Bowers, 1973), results also indicate that differences in item difficulty are not specific to hypnosis, but instead are related more broadly to imagination.     

When is it safe to switch from oral contraceptives to hormonal replacement therapy?

Women may continue to use oral contraceptives (OCs) into their 40's and 50's, but to date no method has been evaluated to ascertain their ovarian status, i.e., whether fertility and estrogen production have diminished sufficiently so they could be safely switched to hormonal replacement therapy. A group of 12 postmenopausal women who had been, for long periods of time, on a regimen of 3 back-to-back packages (i.e., 63 days on, 7 days off) of low-dose oral contraceptives have been studied. Secondly, a group of 9 perimenopausal women aged 36 to 47 were examined in the same manner. The third group consisted of early reproductive age women (arbitrarily divided into subsets aged 17-25 and 26-35 using low-dose OCs in the customary regimen) as normal controls. Blood samples were obtained on the last day of a pill cycle and at 7 days off the pill. In some menopausal women, blood samples were obtained at both 7 and 14 days off OCs. Serum was assayed by RIA for estradiol, FSH and LH. As expected in the young reproductive age women, estradiol levels increase at one week off the pill, together with a rebound in FSH and LH to follicular phase levels. In the perimenopausal group, there was a sharp distinction based on age. The women over 40 showed a more marked rise in FSH while those aged 36-40 showed a distinctly lesser response. Estradiol levels were variable, but tended to show some age grouping. Little diagnostic separation was observed for LH. In postmenopausal women, FSH levels were not always elevated at one week post-pill, and even in a second trial with sampling at one and two weeks off the OC, not all postmenopausal women showed a "menopausal" increase in FSH. The more uniform feature was that estradiol levels never increased above basal values. The study found that serum estradiol levels increase after a week off the pill in controls, but are unchanged at one and two weeks in the menopausal group. FSH levels rebound normally in reproductive age women and usually, but not always, increase substantially in postmenopausal women. After two weeks off OCs, an increased FSH and/or no change in basal estradiol levels is strong evidence that it is now safe (contraceptively speaking) to switch from OCs to standard hormone replacement regimens.     

Fear of contagion: a response to stress?

Alterations of neutrophil functions by tobacco products may play a central role in the pathogenesis of periodontal diseases and several smoking-related systemic diseases. In the present study, we examined the in vitro effects of cigarette smoke on neutrophils at times and concentrations that may be encountered during smoke exposure. We measured the level of smoke exposure in the in vitro system by measuring the levels of nicotine and comparing these to levels in the oral cavity in smokers before and after smoking. We examined both the unstimulated and stimulated release of 2 oxidative burst products: superoxide (O-2) and hydrogen peroxide (H2O2). Salivary washings were collected from 7 smokers (> 1 pack/day) before smoking a cigarette. Immediately after they smoked a cigarette, a second set of washings was collected. In vitro exposure to smoke involved incubating aliquots of neutrophils in phosphate-buffered saline for 1 to 5 minutes. Nicotine and cotinine levels were quantitated using gas chromatography, with detection by electron impact mass spectrometry. Peripheral neutrophils were isolated from medically healthy non-smoking volunteers via a double-density gradient technique and incubated in vitro with whole cigarette smoke for 0 to 5 minutes. Phorbol myristate acetate (PMA; 10(-7) M) was used to stimulate half of the cell aliquots. Superoxide generation was assessed through the superoxide dismutase (SOD) inhibitable reduction of ferricytochrome c. H2O2 production was assessed through the H2O2-dependent breakdown of dichlorofluorescin diacetate to its fluorophore and measured by flow cytometry. There was a marked elevation in salivary nicotine concentration from before smoking (mean: 80.8 ng) to after smoking (mean 1,685 ng/mL). In the in vitro smoke box system, there was a time-related elevation in nicotine from 1 to 5 minutes (50-->136 ng/mL). In PMA-stimulated cells exposed to smoke, there was a time-related inhibition of both superoxide and H2O2 production. However, in unstimulated cells exposed to smoke, there was a time-related increase in the release of superoxide and H2O2. A novel finding in unstimulated cells exposed to smoke was that there appeared to be 2 distinct populations of cells--one of "high" H2O2 producers and one of "low" H2O2 producers. The proportion of high H2O2 producers increased relative to smoke exposure. The relative production of H2O2 in the unstimulated high producers was comparable to PMA-stimulated cells at 5 minutes. This release of superoxide and H2O2 in unstimulated cells exposed to smoke may alter the pathogenic processes both in periodontal diseases and other systemic diseases.     

Are medical specialist interest scales applicable to Negroes?

"Interest scores of 60 Negro seniors from Harvard University Medical College are contrasted with the scores of [a sample of] 150 white seniors… the differences between the two racial groups are small, taking everything into account… .There is no warrant for assuming that the medical specialist interest scales are not applicable to Negroes." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Who requests psychological services upon admission to prison?

Structuring a system of psychological services for offenders and releasees requires an understanding of the offenders who voluntarily seek psychological services upon admission. To begin to develop such an understanding, a sample set of responses to the Psychological Services Inmate Questionnaire (PSIQ) from 2,674 newly committed male and female federal offenders were examined. About one-tenth of the sample made a request for psychological services upon admission to prison without a mandate or referral, and confirm that a combination of prior mental health treatment and current symptoms are among the factors associated with making the request. Logistic regression analysis indicated male gender, receipt of mental health treatment prior to current incarceration, history of a head injury, current symptoms of depression, hopelessness, nervousness, sleeping problems, and racing thoughts, were independent and significant predictors of service request. Implications for future corrections research, clinical training and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Why are stroke patients prone to develop dementia?

Stroke patients are more likely to develop dementia than age- and sex-matched controls but the pathogenesis of dementia remains unresolved in most of them. The aim of this review is to determine, from the available literature, the theoretical reasons for a stroke patient to become demented. We found three distinct factors that may explain the occurrence of dementia after a stroke. Firstly, post-stroke dementia may be the direct consequence of the vascular lesions of the brain: this is the most likely cause in patients with normal cognitive functions before a strategic infarct, especially in young patients, in Icelandic-type hereditary amyloid angiopathy and in cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy. Secondly, post-stroke dementia may be due to an associated asymptomatic Alzheimer pathology; the reasons for such an association are that (1) some cases of dementia occurring after a stroke are progressive and Alzheimer's disease (AD) is the most frequent cause of progressive dementia; (2) age and APOE epsilon 4 genotype are risk factors for both AD and ischaemic stroke; (3) a vasculopathy is often associated with AD. Lastly, white matter changes may also contribute to dementia because they often indicate small-vessel disease and a higher risk of stroke recurrence, and may lead to slight cognitive impairment. Finally, the summation of vascular lesions of the brain, white matter changes, and Alzheimer pathology might lead to dementia, even when each type of lesion, on its own, is not severe enough to induce dementia. Therefore, in patients followed up after a stroke, the term "post-stroke dementia" is probably more appropriate than that of vascular dementia because it includes all possible causal factors.     

When is it safe for babies to swim?

What factors are important when health professionals are asked "At what age is it safe to take my baby swimming in a public pool?". In a survey of primary health care doctors, no unified approach was identified but many considered immunisation essential before swimming. There is no evidence to support this view. Careful attention to the infant's body temperature is more important.     

Relations between needs of friends and fiancés.

This study was undertaken to investigate complementarity and similarity of needs in mate and friendship selection. The Edwards Personal Preference Schedule (EPPS) was administered to 29 clusters of 6 Ss each. A cluster consisted of an engaged couple and a male and female friend of each fiancé. Evidence for similarity of needs in mate and friendship selection, but no consistent evidence for complementarity was found. Engaged couples were significantly alike on 8 of the 15 EPPS needs. In friendship pairings, females select female friends who are like themselves, males select male friends with few similar needs. The male fiancé selects the same type of woman as a friend and as a future spouse, but the female fiancée picks a male friend and a fiancé who are dissimilar. These findings indicate that different processes are involved in the formation of like-sex and opposite-sex pairs fulfilling different interpersonal roles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)