Gestalt therapy and cognitive therapy—Contrasts or complementarities?

The article investigates the relationship between crucial concepts and understandings in gestalt therapy and cognitive therapy aiming at discussing if and how they can be mutually enriching when considered as complementary parts in a more encompassing integrative therapeutic approach. It is argued that gestalt therapy, defined as a field-theoretical approach to the study of gestalt formation process, can complement the schema-based understanding and practice in cognitive therapy. The clinical benefits from a complementary view of the two approaches will be a wider scope of awareness toward individual and contextual aspects of therapeutic change processes, toward different levels of memory involved in these processes, and toward the relationship between basic needs, sensation and cognition in therapeutic work. Further, a dialogue between the two approaches will pave the way for addressing the connection between fundamental awareness work in gestalt therapy and the tendency within cognitive therapy toward incorporating mindfulness as a therapeutic tool. In the conclusion of the article, additional complementary points between the two approaches are outlined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Stunned myocardium"--laboratory curiosity or clinically relevant phenomenon of myocardial failure?

Reversible contractile dysfunction ("myocardial stunning") now is recognized in laboratory animals as well as in the clinic. The precise mechanism(s) responsible for this transient decrease in myocardial contractility is at present unknown. However substantial body of experimental evidence suggest failure in calcium homeostasis due to free radicals injury and calcium overload in ischemic/reperfused myocardium.     

Drug use--chronic and relapsing or a treatable condition?

It is argued that the term "chronic relapsing disorder," which is used frequently to characterize drug use, does not capture the complexity of drug treatment evaluation findings and thereby limits an understanding and appreciation of the accomplishments of drug treatment. Specifically, it is noteworthy that a substantial minority (19%) of treated drug users have been found to maintain abstinence over a 6-year period posttreatment, and that the three major multisite treatment evaluations sponsored by NIDA have all found that overwhelming majorities of treated drug users do not revert to the levels of drug use (or criminal activity) shown pretreatment. Thus, the view of inevitable and continuing adoption of pretreatment behaviors, i.e., chronic relapse, gives undeserved comfort to those who deny the utility of drug treatment, and does so at a time when changes in the health care industry threaten the integrity of that treatment.     

Does a helping hand mean a heavy heart? Helping behavior and well-being among spouse caregivers.

Being a caregiver for an ill or disabled loved one is widely recognized as a threat to the caregiver’s quality of life. Nonetheless, research indicates that helping behavior, broadly construed, promotes well-being. Could helping behavior in a caregiving context promote well-being as well? In the present study, we used ecological momentary assessment to measure active helping behavior and both positive and negative affect in 73 spouse caregivers. Results indicate that when controlling for care recipient illness status and functional impairment and caregiver “on call” caregiving time, active helping predicted greater caregiver positive affect—especially for individuals who perceived themselves as interdependent with their spouse. In addition, although both helping and on-call time predicted greater negative affect for caregivers who perceived low interdependence, helping was unrelated to negative affect among caregivers perceiving high interdependence. Helping valued loved ones may promote caregivers’ well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evolution or revolution?—a new era in billet casting

The billet industry was born in the mid-1960s as a series of scrap recycling plants, at a time when environmental awareness was not even in vogue. Out of the determination and vision of the individuals who forged this industry, a new philosophy of steelmaking emerged. A philosophy based on low man-hours per tonne, and profit sharing gave birth to the highly profitable minimill concept that has now gripped steel production in the flat-rolled area. The billet industry has evolved from being primary suppliers of reinforcing bar to being competitive in high quality products while retaining the original production philosophy. A quiet revolution is now underway in this industry with casting speeds approaching those of thin slab continuous casting. Mould powder lubrication and other practices common to slab casting, such as controlled feeding of liquid steel from tundish to mould in place of metering nozzles are becoming common place. This paper delineates some of the challenges facing the industry which is in the throes of a revolution. Professor Alexander McLean’s early work on the importance of controlling fluid flow in the tundish and its impact on turbulence in the mould is emerging as being critical to the challenge of producing high quality billets at high casting speeds.     

Access to health information and support: a public highway or a private road?

Information and communication technologies may help reduce health disparities through their potential for promoting health, preventing disease, and supporting clinical care for all. Unfortunately, those who have preventable health problems and lack health insurance coverage are the least likely to have access to such technologies. Barriers to access include cost, geographic location, illiteracy, disability, and factors related to the capacity of people to use these technologies appropriately and effectively. A goal of universal access to health information and support is proposed to augment existing initiatives to improve the health of individuals and the public. Both public- and private-sector stakeholders, particularly government agencies and private corporations, will need to collaboratively reduce the gap between the health information "haves" and "have-nots." This will include supporting health information technology access in homes and public places, developing applications for the growing diversity of users, funding research on access-related issues, ensuring the quality of health information and support, enhancing literacy in health and technology, training health information intermediaries, and integrating the concept of universal access to health information and support into health planning processes.     

Lodged bullet or bullet penetration? Re-entry of a projectile and pseudo-shot

In an extended suicide an 11-year-old boy was killed by two shots into the back. In spite of corresponding entry and exit points one of the projectiles was found inside the body. By laying open the respective bullet track, examination of the deformations of the bullet, on which a total of three ricochet points were identified, and a second visit to the scene both the order in which the shots were fired and the reason why one of the projectiles was lodged inside the body, although there was an exit point, could be clarified: On firing the second shot the victim had been lying on the wooden threshold of a door, from which the projectile ricochetted. The terms "reentry" and "pseudo exit point" are discussed. The retention of the bullet in the depth of an alleged exit wound emphasizes the importance of post-mortal X-ray examinations.     

Continuous analgesia with a femoral catheter: plexus or femoral block?

OBJECTIVE: To evaluate the spread and quality of sensitive blockade produced by continuous and prolonged use of a femoral catheter inserted for postoperative analgesia. STUDY DESIGN: Prospective non comparative evaluation. PATIENTS: The study included 20 consecutive patients undergoing major knee surgery with postoperative analgesia obtained with a femoral catheter, a technique commonly used in our department. METHODS: Regional analgesia was induced after surgery with a bolus injection of 30 mL of 2% lidocaine with 1:200,000 epinephrine 1 in 200,000, maintained by continuous infusion of 1% lidocaine + morphine 0.03 mg.mL-1 + clonidine 2 micrograms.mL-1 for 48 h. The infusion rate was 0.1 mL.kg-1.h-1. The evaluation was based on: 1) the quality of analgesia at rest, at 30 min, h1, h3, h6, h12, h24 and h48; 2) the sensitive and motor blockade at the same time intervals. RESULTS: A "3 in 1" block was only observed in 50% of patients after the initial bolus via the femoral catheter. During the maintenance of analgesia with a continuous infusion a blockade of the three main nerves of the lumbar plexus occurred in less than 20% of patients after 6 h and was limited to the territory of the femoral nerve in 45 to 50% of patients after 12 to 48 h. In all cases the median values of VAS were below 42 mm. CONCLUSION: In most patients, a local anaesthetic administered continuously via a femoral catheter produces a blockade limited to the femoral nerve. These data do not substantiate the conclusions by those who consider they are producing a continuous "3 in 1" block with this technique. However, it is obviously not essential to produce a sensitive blockade of the three main nerves of the lumbar plexus to obtain an effective analgesia after knee surgery.     

Is Down syndrome a risk factor for poor outcome after repair of congenital heart defects?

Down syndrome is commonly associated with significant congenital heart disease with the potential for early development of pulmonary hypertension. As such, children with Down syndrome may be at increased risk for both perioperative and long-term mortality. The purpose of this study, using data collected from a population-based outcomes study, is to analyze the potential role that Down syndrome plays in the outcome of surgically "corrected" congenital heart disease. Data were collected from a registry of all Oregon residents who, in the period 1958 to the present, had a reparative operation for one of 14 congenital cardiac malformations when younger than 18 years (N = 3965 patients). Down syndrome was present in 289 (7%) of the total registry patients. In evaluating the cardiac mortality associated with Down syndrome for each of the repaired cardiac malformations, only complete atrioventricular septal defect was associated with significantly higher perioperative (13% vs 5%) as well as higher overall late cardiac mortality through 20 years after the operation (20% vs 5%; p = 0.04). The survival outcomes for each of the other cardiac malformations were similar for children with and without Down syndrome.     

To accept a pilot? Addressing men's ambivalence and altering their expectancies about therapy.

When considering the challenges therapists encounter with their male clients, perhaps the most daunting tasks occur at the very beginning. Getting boys and men to avail themselves of psychological services is the first challenge. But when men do present, the second challenge is to get them to trust therapists sufficiently enough to share their issues and to form an effective working alliance. This article describes these gender-related challenges from male clients' point of view, and then elaborates upon effective techniques to help them engage in and benefit from psychotherapy. We suggest that good therapists for men, like good ship pilots, are informed and prepared. They learn the major cognitive and emotional issues they are likely to encounter with their male clients, and develop a variety of ways to help their male clients navigate the tricky psychological issues of their lives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Blazing angels or resident evil? Can violent video games be a force for good?

Violent video games have been a source of controversy in the United States and elsewhere for several decades. Considerable concern has been raised in the public and scientific communities about the alleged deleterious effects of violent games. These concerns may coincide with periodic moral panics about media's influence, particularly on youth. This paper argues that the negative effects of violent games have been exaggerated by some elements of the scientific community, fitting with past cycles of media-focused moral panics. By contrast, potential positive effects of violent video game play have been ignored in the debate on violent games. The current paper considers research in several areas, including aggression, but also the nascent research fields of visuospatial cognition, social networking, and use as educational tools. It is argued that the debate on video game violence should be broadened to include both potential negative and positive effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maquiladoras and women on the US-Mexican border: a benefit or a detriment to occupational health?

This article examines the impact of work conditions on the health of women working in assembly plants known as "maquiladoras". A sample of 480 women residing in Tijuana and with similar low socioeconomic conditions was studied. The sample included 120 electronics workers, 120 textile workers, 120 service workers and 120 women with no history of labor-force participation. These groups were compared on physical and psychosocial health outcomes, including depression, nervousness, functional impediments and sense of control over life. Data were obtained from interviews conducted in the communities where workers reside. Although high levels of depression and a low sense of control over life was observed, maquiladora workers--particularly in the electronics industry--suffered less functional impediments and nervousness than service workers. However, maquiladora workers were at higher risk of delivering infants of low birthweight.     

"Patient" or "client": What's in a name?

Discusses some aspects of the terms "patient" and "client," especially regarding issues of dependency and responsibility in psychotherapy. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Injury prevention programmes in primary care: a high risk group or a whole population approach?

Assessments of the acceptability of new transplantation practices require a pinpointing of not only the meaning of death, but also the timing of death. They typically perceive elective ventilation as occurring just prior to death and non-heart-beating donor protocols as operative just after death. However, such practices in fact highlight the general vagueness and ambiguity surrounding these issues in both law and ethics. Supply-side dilemmas in transplantation lend real urgency to this "life or death" debate.     

Steelmaking using a solid metallic charge. Electric or fuel melting units?

A continuously operating MAGMA plant is proposed as an alternative to a superpower arc steel-melting furnace in order to increase the utilization of the heat of primary energy carriers and the liquid semiproduct yield in melting of a solid metal charge. The principle of operation of this plant is described, and its operation characteristics are presented in comparison with those of modern electric-steelmaking furnaces.     

How does tele-mental health affect group therapy process? Secondary analysis of a noninferiority trial.

Objective: Video teleconferencing (VTC) is used for mental health treatment delivery to geographically remote, underserved populations. However, few studies have examined how VTC affects individual or group psychotherapy processes. This study compares process variables such as therapeutic alliance and attrition among participants receiving anger management group therapy either through traditional face-to-face delivery or by VTC. Method: The current study represents secondary analyses of a randomized noninferiority trial (Morland et al., in press) in which clinical effectiveness of VTC delivery proved noninferior to in-person delivery. Participants were male veterans (N = 112) with posttraumatic stress disorder (PTSD) and moderate to severe anger problems. The present study examined potential differences in process variables, including therapeutic alliance, satisfaction, treatment credibility, attendance, homework completion, and attrition. Results: No significant differences were found between the two modalities on most process variables. However, individuals in the VTC condition exhibited lower alliance with the group leader than those in the in-person condition. Mean self–leader alliance scores were 4.2 (SD = 0.8) and 4.5 (SD = 0.4), respectively, where 5 represents strongly agree and 4 represents agree with positive statements about the relationship, suggesting that participants in both conditions felt reasonably strong alliance in absolute terms. Individuals who had stronger alliance tended to have better anger outcomes, yet the effect was not strong enough to result in the VTC condition producing inferior aggregate outcomes. Conclusion: Our findings suggest that even if group psychotherapy via VTC differs in subtle ways from in-person delivery, VTC is a viable and effective means of delivering psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting distress-induced eating with self-reports: Mission impossible or a piece of cake?

Comments on the original article, Assessing yourself as an emotional eater: Mission impossible? by C. Evers, D. T. D. de Ridder, and M. A. Adriaanse (see record 2009-20990-009). Results of a functional MRI study (Bohon, Stice, & Spoor, 2009) contradict the assertion that it is impossible to self-assess emotional eating because the self-report emotional eating scale of the Dutch Eating Behavior Questionnaire (DEBQ-em) predicted important individual differences in reward response during negative moods. Evers et al advance their argument in the context of results of four experiments where self-reported “emotional eaters” (DEBQ-em) did not eat more food during emotional encounters as compared to control conditions or “no emotional eaters.” However, the core characteristic of emotional eaters is not that they eat so much during distress (though binge eaters may do), but that they do not show the typical stress response of eating less (the typical stress response being loss of appetite because of physiological effects that mimic satiety) (Gold & Chrousos, 2002). Accordingly, the moderator effect of emotional eating during distress would be that. “No emotional eaters” eat less and “emotional eaters” eat the same or more compared to control conditions. Close inspection of the results of Evers et al reveals that their “no emotional eaters” did not show the typical stress response of eating less. This opens the possibility that the null findings of Evers et al may be simply explained by misclassification of “no emotional eaters” versus “emotional eaters” because of their use of median splits (a procedure notorious for possible misclassification of subjects into distinct groups). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two-Dimensional Simulation of Subcritical Flow at a Combining Junction: Luxury or Necessity?

Classically, in open-channel networks, the flow is numerically approximated by the one-dimensional Saint Venant equations coupled with a junction model. In this study, a comparison between the one-dimensional (1D) and two-dimensional (2D) numerical simulations of subcritical flow in open-channel networks is presented and completely described allowing for a full comprehension of the modeling of water flow. For the 1D, the mathematical model used is the 1D Saint Venant equations to find the solution in branches. For junction, various models based on momentum or energy conservation have been developed to relate the flow variables at the junction. These models are of empirical nature due to certain parameters given by experimental results and moreover they often present a reduced field of validity. In contrast, for the 2D simulation, the junction is discretized into triangular cells and we simply apply the 2D Saint Venant equations, which are solved by a second-order finite-volume method. In order to give an answer to the question of luxury or necessity of the 2D approach, the 1D and 2D numerical results for steady flow are compared to existing experimental data.     

Oral glucose tolerance test: an inhibitory or a stimulatory input to growth hormone secretion?

Two hundred years ago--in May 1796--Edward Jenner carried out a pioneering feat in the history of "clinical investigation' which not only paved the way for the eventual elimination of one of the world's most terrifying infections (variola), but also heralded widespread vaccination campaigns and the foundation of the discipline of clinical immunology. Vaccination superseded the formerly used technique of variolation which had been introduced into England by Lady Mary Wortley Montague. Under-recognised is the fact that the first clinical trial(s) of this new development were carried out under the supervision of William Woodville at the St Pancras Smallpox Hospital (situated at Battle Bridge--now King's Cross); this work was crucially important in the 'vaccination saga' and deserves far greater acceptance than is currently the case.     

Is apathy a valid and meaningful symptom or syndrome in Parkinson's disease? A critical review.

Objective: To review the nearly 30 papers suggesting that apathy may occur frequently in Parkinson's disease (PD) and that it may be a symptom or syndrome that is separate from depression. Method: Literature review. Results: The review revealed three possible explanations for the high rates of apathy found in PD. First, there is much interest in an endogenous explanation of apathy because the basal ganglia and dopamine are implicated in both PD and apathy. Researchers have suggested links between apathy, dopamine depletion, and basal ganglia dysfunction in PD. Second, apathy in PD may be exogenous, resulting from disability and activity restriction. Third, apathy findings are inflated due to conceptual problems and methodological confounds. Indeed, apathy may be consistently confounded with symptoms of PD, including expressive masking, depression, disability, and cognitive decline. Conclusion: Because apathy has not yet been found to relate to meaningful patient outcomes, and it appears that other factors such as depression and cognition are more strongly related to quality of life than apathy, there is not enough evidence to conclude that apathy is a clinically meaningful syndrome in PD. The role of PD in motivation is of theoretical and practical interest and deserves further research. (PsycINFO Database Record (c) 2011 APA, all rights reserved)