Examination and treatment in cerebrovascular insults. A population-based study from a rural district

A population-based survey of the use of different types of examination procedures and treatments of stroke is presented. The study area was a rural district with one local hospital. During a period of 2 1/2 years, 125 cases of first strokes and 29 recurrences were identified. The incidence of hospitalized first strokes in a population of 33,769 was 1.48 per 1000. The three week mortality was 27%. 30% of the patients were submitted to CT-scanning, and 25% were transferred to a specialist department. Two patients (1.6%) had surgery and 4.8% started anti-coagulation treatment. The survival data are compared with a 50 year-old Danish survey. Better survival is seen among patients who are initially awake or drowsy. Initially semicomatose or comatose patients still have poor prognoses. 5% of all bed-days used by the population surveyed were used for the treatment of acute stroke.     

National survey of ethical practices across rural and urban communities.

This study examines ethical dilemmas and problems that are encountered by psychologists across rural and urban communities. A survey instrument was created on the basis of previous surveys of ethical practices. A national sample of 1,000 psychologists stratified into urban and nonurban practitioners was surveyed; 447 usable surveys were returned. Data analysis revealed significant differences between small town/rural and urban/suburban groups for several ethical categories. Notably, small town/rural psychologists are more likely to encounter several types of multiple relationships than their urban counterparts. Small town/rural practitioners are also more likely to be highly visible, or well-known, in their communities. Qualitatively, respondents described their struggles with dual relationships, and several offered suggestions to cope with boundary issues. These findings suggest the need to study the practice of psychology in rural communities in more depth, to study the impact of rural characteristics on clients and practitioners, and to create a conceptual model of best practices for rural practitioners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

National survey of ethical practices among Chinese psychotherapists.

[Correction Notice: An erratum for this article was reported in Vol 42(5) of Professional Psychology: Research and Practice (see record 2011-23526-002). The following sentence is incorrect: “The APA has long recognized that harm and exploitation could result from dual relationships between patient and therapist (Staykova, 2010).” The correct citation for this statement should be: (APA, 1981, 1990, 1992, 2010; Sturm, 1998). Additionally, the following entry should not be listed in the References: Staykova, J. D. (2010). “On wings as swift as meditation”: A devotional allusion in Hamlet. Notes and Queries, 57, 380–384. doi:10.1093/notesj/gjq109. The correct references are included in the erratum. The authors regret these errors. All versions of this article have been corrected.] The present study is a cross-sectional national survey that investigated the ethical practices in a large representative sample of Chinese psychotherapists (N = 690). The results revealed that 76.4% of therapists had experienced feelings of incompetence, more than 80% of therapists had performed the basic principles of informed consent and confidentiality, 1.9% of the sample had engaged in sexual contact with a client, 1.8% had engaged in dual business relationships with their clients, and 34.2% had provided therapy for acquaintances in their practice. The role of the principles of Confucianism as a major influence on the ethical practices in Chinese psychotherapists is discussed. The results suggested that the Chinese Psychological Society should concentrate efforts on educating trainees on how best to maintain therapeutic boundaries when there was a preexisting relationship between therapist and client. The current Chinese Code of Ethics for Clinical and Counseling Practice (Chinese Psychological Society, 2007) could be modified to better incorporate the characteristics of traditional Chinese culture, for example, considering the value of “face” when stipulating the guidelines of dual relationships. Cross-cultural psychotherapy could benefit the clients by examining the influence of traditional Chinese culture, for example, by paying more attention to the important others of the clients. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The prevalence of dementia in Belgium: a population-based door-to-door survey in a rural community

The project Epidemiology Research on Dementia in Antwerp (ERDA) estimated the prevalence of dementia in a random, population-based sample, stratified for age and sex. The sample of 1,736 elderly was screened at home with the Mini-Mental State Examination. All elderly under the cutoff of 23-24/30 got a diagnostic examination with the Cambridge Mental Disorders of the Elderly Examination and the DSM-IIIR criteria. The prevalence of dementia in the population above 65 years was estimated at 9%. The following age-specific prevalences of dementia (included mild dementia) were found in the age-groups 65-69, 70-74, 75-79, 80-84, 85+: 0.6, 5.1, 7.6, 16.2 and 33.6%. The prevalence of at least moderate dementia was 0.3, 3.9, 4.0, 11.2 and 25.0%, respectively. The prevalence of dementia, vascular dementia and dementia of the Alzheimer type was markedly higher in women than in men.     

A survey of ventilator circuitry changing practices in the UK

The aneurysms of the celiac trunk are the rarest aneurysms of the visceral arteries. From 1958 only 69 cases have been reported in the international literature. They are frequently asymptomatic and their discovery is more often occasional. They can rupture in 15-20% of the cases with a mortality approaching 80% of the cases. This explains the need of a surgical treatment even in the asymptomatic cases. Personal experience in the surgical treatment of a case of aneurysm of the celiac trunk is reported and a survey of the literature on this matter is made.     

Acceptance of surgery for trichiasis among rural Malawian women

We sought to determine the proportion of women with trichiasis who subsequently accepted surgery and to evaluate factors related to acceptance. Women who accepted surgery were more likely to be widows, to be of low socioeconomic status, to live close to a main road, to know another woman who had surgery for trichiasis, and to have trichiasis in both eyes than women who did not accept surgery. Our results suggest that considerable education and encouragement are needed to increase acceptance of surgery for trichiasis.     

Acculturation and Pap smear screening practices among college-aged Vietnamese women in the United States

OBJECTIVE: To evaluate prognostic importance of p53, PCNA and vascularization alteration in patients with locally advanced cervical squamous cell carcinoma (SCC) after combination therapy with 13-cis-retinoic acid (13cRA) and interferon-alpha 2a (IFN-alpha 2a). METHODS: 13cRA and IFN-alpha 2a were administered to patients with locally advanced cervical SCC. Formalin fixed, paraffin embedded tissues sections obtained at pre- and post-therapy, respectively, were stained immunohistochemically with anti-p53, anti-PCNA and anti CD31. RESULTS: p53 alteration was demonstrated in 5/10 patients and 3/10 patients pre- and post-therapy, respectively. There was no correlation between p53 alteration and prognosis. After therapy, two patients with complete response had lower PCNA expression whereas the non-responders demonstrated the opposite result. The vascularization showed a correlation with PCNA and prognosis. In the response group, patients had lower microvessel count while the metastatic group exhibited higher count. CONCLUSIONS: The present study suggests that p53 alteration is neither related to the prognosis of cervical SCC nor is it influenced by the combination therapy while PCNA expression and vascularization might be constitute potential markers for tumorigenesis, prognosis and responsiveness to this novel regimen.     

A survey of instructional practices in Canadian psychology departments.

Results of a survey of 43 heads of psychology and educational psychology departments in Canadian universities indicate that Canadian psychology departments are largely traditional in their approaches to teaching, instructional evaluation, and assessment, and there is little evidence that recent psychological research on learning has made any impact on day-to-day teaching activities. They make only limited use of instructional objectives and criterion-referenced testing and assess students primarily by means of multiple-choice tests, essay examinations, or term papers. It is argued that academic psychologists could do more to promote more effective learning by translating the relevant research findings of their own discipline into pedagogical practice. (French abstract) (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family planning practices and attitudes among former Soviet new immigrant women in Israel

One hundred young new immigrant women from the former U.S.S.R. now living in Israel answered a detailed semi-open questionnaire regarding their knowledge, attitudes and behaviors in fertility and birth control issues. A collective family planning profile of these women is largely in line with that of the urban population of Slavonic U.S.S.R., combining early marriage, early and low fertility, the latter achieved by both abortion and contraception. Most respondents and their partners tried to prevent unwanted pregnancies, usually starting from traditional methods and switching over time to modern ones. An IUD remained most popular contraceptive among parous women, while use of the pill, very rare in the U.S.S.R., has almost doubled upon migration, mostly among younger women. Still, they kept some misleading ideas on the pros and cons of traditional versus modern methods, suggesting lack of adequate information also upon migration. Like their ex-compatriots, our women preferred to solve their birth control problems without external professional involvement. Contrary to the expected, free abortion ideology was not universally advocated by our respondents, and most were fully aware of abortion limitations in Israel. While rationally condemning abortion in both moral and health terms, most respondents still use it, this gap between beliefs and practice being indicative of their readiness to adopt efficient contraception. This switch occurs faster in women actively involved with host society via work or studies. Younger women were found to be more flexible and advanced in their family planning practices than were older ones, while almost no differences were related to education and origin within the U.S.S.R. This exploratory study suggests that any investment into promotion of healthy fertility control practices among new immigrants will be cost-effective in the near future.     

A survey of management practices for isolated systolic hypertension

OBJECTIVE: To determine the management practices of clinicians for patients with isolated systolic hypertension, with particular attention to treatment thresholds, medication choices, and target blood pressures. DESIGN: Self-administered questionnaire. SETTING: Edmonton, Alberta, a large Canadian city. PARTICIPANTS: A random sample of 348 family physicians and 125 internists. MEASUREMENTS: Demographics of the respondents, first and second choice of antihypertensives, treatment thresholds, and target blood pressures for patients with isolated systolic hypertension. RESULTS: Excluding 54 nondeliverable questionnaires, a response rate of 67% (281 surveys) was obtained. The responding clinicians reported treatment thresholds and target blood pressures consistent with the evidence from randomized clinical trials and the recommendations of the Canadian Hypertension Society and the Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Thiazide diuretics were recommended as first line therapy by 74% of internists and 58% of family physicians. Angiotensin converting enzyme inhibitors were the most frequently chosen second line drug (27% of internists and 45% of family physicians). CONCLUSIONS: The reported management practices of this group of clinicians are consistent with the evidence from randomized clinical trials and the recommendations of national consensus guidelines.     

Contemporary psychotherapists: A national survey of characteristics, practices, orientations, and attitudes.

Surveyed a representative sample of American psychologists engaged in psychotherapy concerning their characteristics, activities, affiliations, theories, and selected attitudes. 410 members (aged 24–79 yrs) of Division 29 (Psychotherapy) of the American Psychological Association responded to an 82-item questionnaire. Survey results are described and compared to the findings of a similar survey by J. C. Norcross and J. O. Prochaska (e.g., see record 1982-21987-001) of American clinical psychologists (Division 12 members). Among the most salient findings were that (1) over 80% of Ss have had personal therapy and highly value these experiences as preparation for providing therapy; (2) individual therapy is the most popular therapeutic modality, but over one-half of the Ss engage in marital and family therapy; (3) while therapists spend relatively small percentages of their time doing research, they do as a group publish and present papers; (4) private practice is the modal affiliation of the Ss and may be the most equitable employment setting; and (5) psychodynamic orientations have experienced renewed preference with eclecticism declining, suggesting a need for more integrative models of therapy. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A national survey of percutaneous central venous catheter practices in neonates

PURPOSE: This study was conducted to describe current practices for maintenance of percutaneous central venous catheters (PCVCs). DESIGN: A survey technique was used. SAMPLE: A national mailing to 511 nurseries resulted in a response from 309. Of those who responded, 206 reported using PCVCs. MAIN OUTCOME VARIABLE: Maintenance practices for PCVCs. RESULTS: The most common catheter site preparation technique was the use of Betadine, or Betadine and alcohol. Transparent dressings were the most commonly used site cover, and were changed when loose or soiled. Contamination precautions varied; most nurseries used Y-administration sets and extension tubing for medication administration into the PCVC system.     

A survey of dairy cattle worm control practices in southeast Brazil

A survey on the nematode control strategies utilized by dairy farmers in Southeastern Brazil, a region accounting for 46.4% of the national milk production, was conducted through interviews with farmers. To select the producers to be interviewed the region was split into 16 non-contiguous clusters, according to the level of milk production. A systematic sample was then selected in each of the clusters. The interview questionnaire consisted of one-way, multiple-choice and open-ended questions. Data collected were represented by numbers and digitized on a data base (Epi Info, version 5.01b) and analyzed. Out of the 89 farmers interviewed, 37.5% deworm their herd after clinical signs and 62.5% preventively. Generally, anthelmintics are applied from one to 12 times a year (average of 3.79 times a year) in all age categories of animals. Of the anthelmintics used in the last deworming, imidazothiazole was used exclusively by 17.1% of the farmers, benzimidazole by 9.8% and avermectin by 18.3%, while 55.8% used more than one anthelmintic class to deworm their animals. To choose the dosage, most farmers consult the product label (94.8%) and determine the volume to be applied, based on an estimate of the average body weight of each animal (62.9%). Improvements in the general appearance of the herd and weight gains of growing animals were observed by most farmers after deworming (87.3%). However, most of them (66.2%) recalled interrupting the use of some compound in the last few years, due to the detection of no improvement following treatment (32.7%), rising costs of the medication (28.6%), adverse reaction (8.2%), product not available at the time of purchase (4.1%) and decision to change the compound in use (10.2%). Most farmers (95.3%) intend to continue using the same control measures in the following year. Veterinarians play an important role in the farmer's choice to deworm their animals, as many seek advice from them. Therefore, programs aimed at technology transfer should include continuous updates on the subject, especially for veterinarians.     

A survey of the practices and activities of Canadian clinical psychologists.

To document the nature of clinical psychology in Canada, a national survey was conducted to collect data on clinical psychologists' demographic characteristics, professional affiliations, professional identities, therapeutic orientations and activities, and publications. 88 members of the Canadian Register of Health Service Providers in Psychology returned questionnaires. 73% of the Ss regarded themselves primarily as clinical practitioners; over 70% had made at least one presentation at a professional meeting. Findings reveal that most Ss (1) are engaged in private practice to some extent, (2) conduct psychotherapy, and (3) can be characterized as eclectic in orientation. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Juvenile competence to stand trial evaluations: A survey of current practices and test usage among psychologists.

What is the current standard of practice for evaluations of juvenile competence to stand trial (JCST)? The present study surveyed psychologists regarding the practices used when conducting JCST evaluations. Respondents rated the importance of 17 elements that might be included in a JCST evaluation report. Of these elements, 7 were considered essential by 70% or more of respondents, with 9 additional elements rated as either essential or recommended. A majority of respondents felt that the use of psychological and forensic instruments was important. A list of tests used is provided, and the implications for the development of standards and policy are discussed to provide practitioners with additional knowledge that will help to further the state of the discipline. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Epidemiological study of primary intracranial tumors in childhood. A population-based survey in Kumamoto Prefecture, Japan

Between 1989 and 1995, we diagnosed primary intracranial neoplasms in 79 children younger than 15 years. All of them belonged to a well-defined population residing in Kumamoto Prefecture, Japan. Of the tumors, 64 (81.0%) were confirmed microscopically. The age-adjusted annual incidence rate was 34.3 cases per million child population. There was a marked difference in the incidence rate between boys (47.1) and girls (22.05). The age-specific annual incidence per million was 24.3 cases for the 0- to 4-year age group, 46.7 for the 4- to 9-year age group and 30.8 for the 10- to 14-year age group. The highest incidence rate was seen in 5- to 14-year-old boys (53.5), the lowest in 10- to 14-year-old girls (7.1). The most common tumors were astrocytomas (41.8%), with an incidence of 14.52 per million, followed by germ cell tumors (15.1%), with an incidence of 6.24 per million, craniopharyngiomas (15.1%), incidence 5.25 per million, ependymomas (6.3%), incidence 2.19 per million, and medulloblastomas (6.2%), incidence 2.19 per million. The distribution of tumor types varied with patient age at the time of diagnosis. Although no germ cell tumors were encountered in the 0- to 4-year age group, in the 10- to 14-year age group, they comprised about one third of all tumors. In contrast, white craniopharyngiomas were rare in the 10- to 14-year age group, they made up more than 22% in the 0- to 4-year age group. In this survey of Japanese children, we found a higher incidence of primary intracranial tumors, especially germ cell tumors and craniopharyngiomas, and a lower incidence of medulloblastomas compared to the incidence reported for Western countries.     

Cancer risk among women with cosmetic breast implants: a population-based cohort study in Sweden

Complementary DNAs encoding the heavy and light chains of the Fab fragment of mouse agglutinating monoclonal antibody against human red blood cells were cloned by polymerase chain reaction and their nucleotide sequences were determined. The sequence analysis showed that the variable regions of the heavy and light chains were the members of mouse heavy-chain subgroup IIa and kappa light-chain subgroup I, respectively. A few unusual amino acids in the constant regions of the heavy chain were also recognized.     

Psychotherapy supervision: A survey of internship training practices.

A survey of 151 American Psychological Association-approved predoctoral internship programs showed a ratio of 3 hrs of psychotherapy provided by interns to 1 hr supervision received by the intern. Interns received an average of 4.25 hrs/wk of supervision, and the supervisory staff provided an average of 3.76 hrs/wk of supervision. One-to-one supervision was the predominant supervisory modality. Supervision was considered part of the job, not something to be specifically rewarded. No specific and direct evaluation procedures to assess supervision quality were available. One-third of the facilities reported that they provided training in supervision for interns. Programs could be characterized as "open" (accepting other than graduate psychology interns) or "closed" and more or less intensive in providing supervision. The dimensions of openness and intensity were related to the types and amounts of supervision provided. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ancylostoma duodenale is responsible for hookworm infections among pregnant women in the rural plains of Nepal

PURPOSE: To evaluate retrospectively the optimum dosage of irradiation for Kimura's disease. METHODS AND MATERIALS: Twenty patients with Kimura's disease were treated with radiotherapy. The sex ratio was 19 males to 1 female. The mean ages at onset, initial treatment, and radiotherapy were 26.2, 29.5, and 32.2 years, respectively. Radiotherapy was mainly applied for residual or recurrent tumors. The eosinophil count increased by more than 10% in 18 of the 20 patients. In most instances, irradiation was given through a single field with dosages ranging from 20 to 44 Gy. RESULTS: At the completion of radiotherapy, a marked response in tumor size was noted in all cases. The minimum follow-up was 48 months. Local control was obtained in 23 of 31 lesions (74.1%). At dosages of < or =25 Gy, 26-30 Gy, and > 30 Gy, local control was obtained in 2 of 8 (25.0%), 9 of 10 (90.0%), and 12 of 13 sites (92.3%), respectively. CONCLUSIONS: Radiotherapy is an effective treatment for Kimura's disease. This strongly suggests that no surgical procedure other than a biopsy should be carried out. The radiation field should be limited to the lesion and swelling of the adjacent lymph nodes as much as possible, with a optimum dosage of 26-30 Gy regardless of tumor size.