Transferring psychotherapy clients: State of the art.

Transferring psychotherapy clients from one therapist to another is a common event that may pose clinical and administrative problems. Clinicians and therapists in training transfer clients when their professional role or activities change or when they leave their clinical settings. We review the literature on transferring psychotherapy clients and report on aspects of the transfer process and procedures used by a national sample of psychology training clinics. We also report and discuss the results of an exploratory analysis training clinic records in which we investigated the relation between transfer outcome (successful vs. unsuccessful) and a set of treatment and demographic factors. Last, we suggest several ways of handling difficulties that arise as a result of clinical and administrative reassignment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

State of the art case management

Case management traditionally has been performed by occupational health nurses and rehabilitation professionals. The rapid growth of managed care was the impetus for defined standards and formal credentialing.     

Researching disturbed family systems: State of the art.

Reviews the book, Family interaction and psychopathology: Theories, methods, and findings edited by T. Jacob (see record 1987-97733-000). Prior to this work, the literature on family interaction and psychopathology was scattered across many disciplines, making it difficult for scholars to take full advantage of the progress and pitfalls in family interaction research. This volume goes a long way toward remedying that situation. As the title suggests, the book is subdivided into three major sections: (a) Conceptual Foundations, (b) Methodological Issues and Strategies, and (c) Family Research on Specific Psychopathologies. Each of these sections can stand on its own as a comprehensive and current contribution to its respective area of concern. The book as a whole provides many guidelines and insights for study preparation and, consequently, may become a major resource for the prospective researcher. The reviewer strongly recommends this book to family psychologists to serve as a handbook on family psychopathology. Researchers informed by the theories, methods, and findings presented in Jacob's book, and who take advantage of powerful research techniques, will clearly be at an advantage in making significant contributions to this field in the years to come. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropeptides and the puzzle of bone remodeling. State of the art

Bone metabolism is dependent on cells of the osteoblast and osteoclast lineage. These cells play a major role in the synthesis and degradation of osteoid and in its mineralization and demineralization. Bone cells are under the influence of various systemic and local auto/paracrine factors. One further regulatory element that can play both a sensory/ afferent and a regulatory/efferent role, consists of neuropeptide-containing nerves. In particular, the calcitonin gene-related peptide (CGRP) and vasoactive intestinal peptide (VIP) have been implicated; their distribution in bone and their molecular biology are discussed in some detail. Bone neuropeptides can function as direct bone cell regulators, with additional amplifying indirect effects mediated by vascular endothelial cells, monocyte/macrophages and mast cells and their mediators. Recent experimental and clinical work has implicated bone nerves in processes varying from normal remodelling to fracture healing and non-union. Apart from systemic endocrine influences on bone stock and osteoclast/ osteoblast coupling (activation-resorption-formation cycle) mediated by local auto/paracrine factors, bone nerves/neuropeptides may explain why various inputs/outputs are transformed in a meaningful way to altered mass and quality of bone.     

State of the art in coronary angioplasty

Based on a literature overview and on his personal experience with the method, the author analyzes the different phases in the evolution of coronary angioplasty, its indications and limitations in the contemporary setting, as well as the impact of new devices. He emphasizes: the value of the balloon as a basic instrument, followed by the stent; the various attitudes related to the technique; prevention and management of complications during and after the procedure; development, prediction and management of coronary restenosis.     

Breast cancer screening. State of the art and introduction to preventive measures

Carcinoma of the breast is the most frequent cause of death in women aged between approximately 38 and 50 years. At present, 1 out of 14 women in Germany and 1 out of 9 in America suffer from breast cancer within a life time. To date, modern methods of treatment and hormone therapy have only been able to increase long-term survival by about 12%. Trials have shown that early diagnosis alone has been able to increase survival from 20% to 50%. Early diagnosis proved to be most effective when clinical examination plus mammography in two planes was carried out annually. An increase in survival has been achieved in post-menopausal women as a result of screening. 22 percent of breast cancers were detected at a curable in situ stage by means of screening. Even after a limited screening program of 4 examination cycles the increase in survival rate over 15-20 years was significant.     

State of the art in sequential analysis: Comment on Lichtenberg and Heck.

Comments on the discussion of J. W. Lichtenberg and E. J. Heck (see record 1986-30903-001) on methods to analyze sequential data in the context of counseling process research. The present author outlines the state-of-the-art developments in sequential analysis, including unidirectional and bidirectional tests, tests of dominance, between-group and overtime tests, and tests for systems with more than 2 participants. In addition, a number of caveats for conducting a sequential analysis are presented. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

State of the art: "diastology" research 1998

The performance of the left ventricle (LV) during diastole is defined by the pressure-volume relationship. Consequently, noninvasive techniques have been limited in the evaluation of diastolic function by their inability to evaluate intracardiac pressure, particularly LV filling pressure and end-diastolic pressure. Abnormalities of LV diastolic function play a major role in producing the clinical signs and symptoms of heart failure. Previous studies have demonstrated that the transmitral flow (TMF), pulmonary venous flow (PVF) and left atrial appendage flow (LAAF) velocity patterns determined by pulsed Doppler echocardiography are useful parameters for evaluating left atrial (LA) and LV hemodynamic events. However, these variables are influenced by loading conditions, particularly preload. Furthermore, it has become increasingly clear that abnormalities of LV diastolic function, such as relaxation and filling, can be assessed precisely using color Doppler M-mode echocardiography and pulsed tissue Doppler imaging irrespective of preload. This review presents a clinical approach to understanding the hemodynamic abnormalities of the LA and LV in a variety of cardiac diseases using these new modalities. In addition, the limitations of these techniques are discussed.     

Evidence-based interventions in school psychology: State of the art and directions for the future.

Introduces articles in this special issue of School Psychology Quarterly which is designed to provide a current snapshot of the accomplishments and controversies pertaining to evidence-based intervention in school psychology. It is argued that evidence-based intervention guidelines will prove to be akin to professional codes of ethics in that they are both works that will always be unfinished rather than being completed in any ultimate sense. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Decoupling: theory and practice. II. State of the art: in vivo applications of decoupling

Current methods for broadband heteronuclear decoupling are reviewed from a historical perspective. The principal concern is that decoupling should be effective over a wide range of chemical shifts without undue radiofrequency heating of the sample, particularly when human patients are involved. Continuous-wave methods are the least efficient in this respect, followed by noise decoupling. Composite pulse schemes offer a more effective use of radiofrequency power, while adiabatic passage methods are the most efficient of all. Bi-level decoupling employs a low level of radiofrequency irradiation during the relaxation delay to maintain the nuclear Overhauser effect, with a higher level during signal acquisition in order to decouple over a wide frequency band. All decoupling sequences introduce cycling sidebands into the observed spectrum, and schemes are described to minimize the intensity of these artifacts. In part II, practical applications of decoupling methods are examined in the context of in vivo spectroscopy, where the improvements in sensitivity and resolution through broadband decoupling can be critical for solving clinical problems. Attention is focused on the regulatory limits on power deposition in these experiments. A tabulation of the existing work on decoupling in biological tissue is presented, mainly involving 31P and 13C spectroscopy in vivo or in vitro.     

State of the art and development trends in powder metallurgy abroad

Data are given on the current state of the art in powder metallurgy PM in industrially developed countries. Indications are given of the output of powders and PM products for the period from 1986 to 1991 together with the PM product consumption structure. There is a discussion of the main trends in PM abroad up to the year 2000.Materials Science Institute, National Academy of Sciencesof Ukraine, Kiev. Translated from Poroshkovaya Metallurgiya Nos. 3–4, pp. 111–118, March–April, 1994.     

State of the art in the control of inclusions during steel ingot casting

This article extensively reviews published research on inclusions in ingot steel and defects on ingot products, methods to measure and detect inclusions in steel, the causes of exogenous inclusions, and the transport and entrapment of inclusions during fluid flow, segregation, and solidification of steel cast in ingot molds. Exogenous inclusions in ingots originate mainly from reoxidation of the molten steel, slag entrapment, and lining erosion, which are detailed in this article. The measures to prevent the formation of exogenous inclusions and improve their removal are provided, which are very useful for the clean steel production of ingot industries.     

Lateral release of the patella. I--Diagnostics, indications

Basic principles of diagnostics of the patello-femoral joint are presented. Indications for arthroscopic subcutaneous patellar lateral release are discussed.     

Radiographic changes in the patella after total knee arthroplasty without resurfacing the patella. Comparison of osteoarthrosis and rheumatoid arthritis

Two groups of patients were studied, both in accordance with ACR criteria. First group (41 cases) suffering R.A. Second group (36 cases) suffering O.A. In both pathologies MMPs, ICAM and VCAM from synovial fluid and plasma were studied. Measurements were made with ELISA-sandwich in a Metrolab spectrophotometer at 410 nm for MMPs, and 491 nm for ICAM and VCAM. As control, samples of patients with noninflammatory muscle skeletal disorders or traumatic arthritis and healthy witness were used. Synovial concentration of MMPs in R.A. was 1402 +/- 76 ng/ml, a higher significant value (p < 0.0001) compared with osteoarthritis: 353 +/- 23 ng/ml. In the witness plasma, MMPs were not detected. Plasmatic and synovial levels of the adhesion molecules present different values in both pathologies and between them. Synovial ICAM level in R.A. (280 +/- 9.8 ng/ml) is significantly higher than in O.A. (163 +/- 10 ng/ml) (p < 0.001), but lower than the plasmatic ones (370 +/- 35 ng/ml) (p < 0.001). All these values are significantly higher than the normal plasma (121 +/- 6.5 ng/ml) (p < 0.01, p < 0.005, and p < 0.0001, respectively) VCAM increase regarding basal values (140 +/- 5.6 ng/ml) (p < 0.001) and in a similar proportion for both pathologies (R.A.: 186 +/- 9.3 ng/ml and O.A.: 207 +/- 14.3 ng/ml). Their plasmatic levels were higher (270 +/- 45 and 320 +/- 38 ng/ml) (p < 0.001) but without significative difference between them. There is correlation among MMPs, ICAM and VCAM variations. The variability can be explained by concomitance several evolutive steps. Each pathology shows a different grade of cellularity, inverted predominance in the relation TIMPs/ collagenase and different generator mechanisms of MMPs. Our findings reinforce the importance as diagnostic guide of adhesion molecules dosage, and possible therapeutic use of MMPs inhibitors and ICAM or VCAM antagonists en R.A. and related pathologies.