Paradoxical treatments: A unified concept.

Reviews 3 theories of paradoxical treatments: V. E. Frankl's (1967) concept of hyperintention, the behaviorists' concept of conditioned inhibition, and J. Haley's (1974) concept of the therapeutic double bind. A unifying theory of modification of symptom context is proposed that may better explain the various successful methods of paradoxical treatment. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The therapeutic dialogue in narco-analytic treatments.

Gives an impressionistic review of 40 narco-analytic treatments of soldiers who suffered a subacute combat reaction in the 1973 Israel War. The criteria for the application of this treatment are discussed. Narcotherapy is characterized by the intensity of the emotions expressed, leading to problems of transference and countertransference that must be dealt with. Emphasis is placed on the existential aspects encountered in the reliving of traumatic battle experiences. While helping the patient to return to the traumatic past, the therapist simultaneously gives him support derived from the immediate context of the therapeutic dialog. The conclusions drawn from this material can be used as directives for therapists who use narcoanalysis as a form of short-focal psychotherapy. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The dissemination and implementation of evidence-based psychological treatments: A review of current efforts.

Recognizing an urgent need for increased access to evidenced-based psychological treatments, public health authorities have recently allocated over $2 billion to better disseminate these interventions. In response, implementation of these programs has begun, some of it on a very large scale, with substantial implications for the science and profession of psychology. But methods to transport treatments to service delivery settings have developed independently without strong evidence for, or even a consensus on, best practices for accomplishing this task or for measuring successful outcomes of training. This article reviews current leading efforts at the national, state, and individual treatment developer levels to integrate evidence-based interventions into service delivery settings. Programs are reviewed in the context of the accumulated wisdom of dissemination and implementation science and of methods for assessment of outcomes for training efforts. Recommendations for future implementation strategies will derive from evaluating outcomes of training procedures and developing a consensus on necessary training elements to be used in these efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rheumatoid polyarthritis: therapeutic management

AN OPEN QUESTION: Developing a therapeutic strategy for rheumatoid arthritis is a difficult and much debated task. Recent clinical trials have confirmed the importance of initiating treatment at the onset of disease in all patients with rheumatoid arthritis in order to limit the degree of later progression. INDIVIDUALIZED REGIMENS: Treatment for patients with early-stage rheumatoid arthritis should be adapted individually taking into consideration the expected benefit and risks of drug therapy, the degree of joint inflammation and factors predictive of disease severity which are becoming more and more well understood. PATIENTS IN REMISSION: Treatment should be continued if well tolerated. Treatment should not be discontinued (and then only progressively) unless complete remission has been achieved for a long period. LONG-STANDING DISEASE: The precise therapeutic strategy in patients with long-standing disease remains a question of debate, but does require full-dose combination regimens.     

Focus on therapeutic alliance: The psychometric properties of six measures across three treatments.

The psychometric properties of six measures of therapeutic alliance (California Psychotherapy Alliance Scales; Penn Helping Alliance Rating Scale; Vanderbilt Therapeutic Alliance Scale; and the Working Alliance Inventory- therapist, client, and rater versions) were compared in a sample of 60 substance-dependent individuals participating in a randomized clinical trial of three psychotherapies. Internal consistency, interrater reliability, and intercorrelations among the instruments were evaluated. Results supported the construct validity of the therapeutic alliance and indicated that all six measures had acceptable reliabilities. Correlations between observer and participant measures were comparatively low. Reliabilities did vary, however, by treatment condition, suggesting that psychometric properties, and by extension alliance-process-outcome relationships, may vary across treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A therapeutic taxonomy of treatments for erectile dysfunction: an evolutionary imperative

AIM OF THE STUDY: A functional classification of treatments for erectile dysfunction is important but none exists at present. Advances in the understanding of the mechanisms of drug action and of the mechanisms of penile erection suggest that there is now a rational basis for a therapeutic classification, with the expectation that a logical diagnostic classification will follow. METHODS: The currently available treatments for erectile function and the known relevant basic science were reviewed and assessed. From this, and analysis of classification systems in other fields, a classification was proposed and evaluated with respect to existing treatments. RESULTS: The treatments for erectile dysfunction were classified into five major classes by their mode of action: (I) Central Initiators, (II) Peripheral Initiators, (III) Central Conditioners, (IV) Peripheral Conditioners and (V) Other. Drugs in these classes are further subdivided by the routes of administration and the mechanisms of specificity. CONCLUSIONS: It is possible to analyze all known treatments using this classification. The principles of this scheme should be sufficiently clear as to enable knowledgeable specialists to arrive at similar conclusions about a drug. The classification proposed is general enough such that most new drugs should fall within a class. However, it should be modified if necessary, if new therapeutic agents can not be appropriately classified. It is our conclusion that with such endeavours the specialty itself and national regulatory bodies will find it easier to define and control how to apply new drugs, how to evaluate new drugs, and how to establish reasonable equivalences among agents and in whom these drugs and devices should be used.     

Pulmonary hamartoma: atypical cases and current concept of management

Twenty seven cases of surgically excised pulmonary hamartomas were reviewed. Patient's ages varied from twenty eight year-old to seventy seven year-old with an average of fifty three year-old. Of twenty seven cases, seventeen cases were man, seventeen cases has mass on right lung, and twenty six cases has solitary mass. While twenty five cases were asymptomatic, one case had cough, and the other cases had a history of hemoptysis (Case 3). Medical treatment for pulmonary tuberculosis had been continued unless the confirmed diagnosis on two cases. On one case followed as tuberculosis for twelve years, size of tumor shadow grew to two times bigger on chest X-ray films (Case 1). One of 27 cases showed multiple mass (Case 2). Histopathologically, twenty six cases were chondromatous hamartoma, and one case was non-chondromatous hamartoma. Pulmonary hamartoma is a benign tumor, and majority of cases are asymptomatic and not growing. On cases with presumed pulmonary hamartoma, less invasive thoracoscopic surgery seemed valuable for both therapeutic and diagnostic purpose to avoid continuous non-rational treatment and mental pressure of patient by prolonged follow up with unconfirmed diagnosis since complete differentiation from malignant neoplasm should not satisfactory on many cases.     

Maintenance of therapeutic gains: Issues, problems, and implementation.

The lack of definitive research on the maintenance of therapeutic gains is discussed, and many of the various singular approaches to achieving maintenance are critically appraised. Although maintenance cannot be guaranteed, combining various strategies appears to increase the chances of achieving it. Self-regulation has become the pivotal point of maintenance, with the individual learning coping strategies to use in future problem situations. The environmental social system approach appears necessary for long-term maintenance, but its expense and longitudinal nature have precluded its full implementations. Research efforts used to evaluate maintenance are examined and found to be lacking methodologically, reflecting the current inefficient approach to the problem of maintenance. Suggestions are made to remedy this situation. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparative evaluation of therapeutic components associated with behavioral marital treatments.

Investigated the relative effectiveness of 3 therapeutic components common to behavioral marital therapies: procedures designed to change behavior, procedures to change attitudes, and nonspecific therapeutic effects. A hierarchical ordering of these components produced 3 treatment conditions—nonspecific, behavioral, and behavioral–attitudinal. 77 20–72 yr old couples experiencing marital distress were randomly assigned to 1 of the 3 treatment conditions and 1 of 5 paraprofessional counselors. After 4 therapy sessions, the groups were compared on measures of self-reported satisfaction (Locke-Wallace Marital Adjustment Test, Areas of Change Questionnaire and Adjective Check List), daily reported pleasing (or displeasing) relationship events (Spouse Observation Checklist), and observations of communication skillfulness (Marital Interaction Coding System). All groups showed significant decreases in negative relationship behaviors. The behavioral–attitudinal group, compared to the other groups, showed significantly greater improvement in reported marital satisfaction, pleasing behaviors, and positive communication responses. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A severe form of acute pancreatitis--a new concept in therapeutic protocols

The authors submit for discussion a modified concept of treatment of acute pancreatitis, used in their department. They emphasize the evaluation of severity and assessment of the development of the disease. They extend the therapeutic pattern by continual regional arterial infusion, early enteral nutrition and facultative laparoscopic exploration with lavage of the abdominal cavity. They include haemopurification methods in the protocol of treatment.     

钢包管理系统的设计与实现

为提高炼钢厂钢包运行效率,以秦皂岛首秦金属材料有限公司炼钢厂钢包为研究对象,解析其周转过程,设计出钢包管理模式;引入钢包个数计算法并提出钢包运行的2个评价指标,形成钢包运行优化模块;最终实现钢包的计算机化管理.应用表明:系统可有效减少钢包周转周期和投入个数,提高钢包的周转率和连续化程度.     

Has the concept of the therapeutic alliance outlived its usefulness?

In this article, we provide a brief summary of our current thinking about the constructs of the therapeutic alliance and ruptures in the therapeutic alliance. We speculate about some of the factors that have led to sustained interest in these constructs by psychotherapy researchers and discuss some of the conceptual problems associated with them. We also consider the question of whether the therapeutic alliance continues to be a meaningful construct, and we delineate more and less promising avenues of research for the future. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

教务管理信息系统的设计与实现

从校园信息化结构入手,对教务管理信息系统的功能、设计、应用、优缺点等方面进行分析,阐述了教务管理信息系统开发的重要性、必要性和可行性。     

包钢营销管理信息网络平台的构建与实施

通过对原销售业务流程再造,运用现代网络技术建立起包钢营销管理信息网络平台,使包钢的营销管理水平上了一个新台阶.