Aggression and the psychic self

In this paper we explore the idea of aggression as a defence against threats to the psychological self. This aspect of the self allows reflection about people in psychological terms and develops, in the first three years of life, through appreciation of mental states in the other. When the object is unpredictable or hostile, recognition of this is painful to the child, and his reflective function will not be adequately established. The defences of aggression or avoidance will be invoked very frequently. In time, aggression may become an organising influence in the construction of the self; pathological destructiveness then takes the place of emotional relatedness and concern for the other. Psychoanalytic treatment no longer works primarily by addressing conflict. Instead, particularly through interpretations of transference and countertransference, the analyst recreates an intersubjective process which enhances the patient's reflective self, this time in the safety of a benign relationship.     

Systemic lupus erythematosus in three ethnic groups: II. Features predictive of disease activity early in its course. LUMINA Study Group. Lupus in minority populations, nature versus nurture

OBJECTIVE: To determine the factors associated with disease activity in patients with recent-onset (< or =5 years) systemic lupus erythematosus (SLE) who were of Hispanic, African-American, or Caucasian ethnicity. METHODS: Incident and prevalent cases of SLE, as defined by the American College of Rheumatology criteria for SLE, among the 3 ethnic groups were identified in Alabama (The University of Alabama at Birmingham) and Texas (The University of Texas-Houston Health Science Center and The University of Texas Medical Branch at Galveston). Variables from the sociodemographic, clinical, immunologic, immunogenetic, behavioral, and psychological domains were obtained using validated instruments. Disease activity was ascertained with the Systemic Lupus Activity Measure (SLAM). Stepwise domain regressions with SLAM score as the dependent variable were performed. Final ethnic-specific and overall regression models were obtained by entering variables that were retained in the domain regressions. RESULTS: SLAM scores at study entry were higher in the African Americans (mean +/- SD 12.6 +/- 6.9) and Hispanics (11.0 +/- 6.2) than in the Caucasians (8.5 +/- 3.7) (P < or = 0.001). The final overall regression model (R2 = 28%) for higher SLAM score included the following variables: African-American ethnicity, lack of private health insurance, abrupt disease onset, presence of anti-Ro antibodies, absence of HLA-DRB1*0301, higher levels of helplessness, and abnormal illness-related behaviors. CONCLUSION: Socioeconomic, immunologic, immunogenetic, behavioral, and psychological variables were all predictive of disease activity early in the course of SLE, irrespective of ethnic group. However, there remain ethnic group differences in disease activity that were not explained by these factors.     

The safer choices project: methodological issues in school-based health promotion intervention research

Randomized trials of school-based health promotion programs present unique design and analytical issues not widely discussed in the research literature. This article describes the Safer Choices study--a school-based program for prevention of HIV, other sexually transmitted diseases, and pregnancy--to illustrate critical methodological issues involved in large-scale, school-based intervention trials, particularly those evaluating interventions with a school-wide focus. The issues presented are: 1) comparability of the intervention and control groups even when few units are randomized; 2) factors that affect the decision to use a cohort or cross-sectional design; and 3) appropriate analysis strategy when the unit of randomization and intervention is at the school level, but observations are at the student level.     

Fluctuating NMDA Receptor Subunit Levels in Perirhinal Cortex Relate to Their Dynamic Roles in Object Memory Destabilization and Reconsolidation

Reminder cues can destabilize consolidated memories, rendering them modifiable before they return to a stable state through the process of reconsolidation. Older and stronger memories resist this process and require the presentation of reminders along with salient novel information in order to destabilize. Previously, we demonstrated in rats that novelty-induced object memory destabilization requires acetylcholine (ACh) activity at M₁ muscarinic receptors. Other research predominantly has focused on glutamate, which modulates fear memory destabilization and reconsolidation through GluN2B- and GluN2A-containing NMDARs, respectively. In the current study, we demonstrate the same dissociable roles of GluN2B- and N2A-containing NMDARs in perirhinal cortex (PRh) for object memory destabilization and reconsolidation when boundary conditions are absent. However, neither GluN2 receptor subtype was required for novelty-induced destabilization of remote, resistant memories. Furthermore, GluN2B and GluN2A subunit proteins were upregulated selectively in PRh 24 h after learning, but returned to baseline by 48 h, suggesting that NMDARs, unlike muscarinic receptors, have only a temporary role in object memory destabilization. Indeed, activation of M₁ receptors in PRh at the time of reactivation effectively destabilized remote memories despite inhibition of GluN2B-containing NMDARs. These findings suggest that cholinergic activity at M₁ receptors overrides boundary conditions to destabilize resistant memories when other established mechanisms are insufficient.     

Study of the telomerization of dimethylaminoethyl methacrylate (DMAEMA) with mercaptoethanol. Application to the synthesis of a new macromonomer

The telomerization of dimethylaminoethyl methacrylate (DMAEMA) with mercaptoethanol initiated by 2,2′-azobisisobutyronitrile was first investigated at 70 °C and the influence of the type of solvent was studied. The results showed that well-defined telomers of DMAEMA could not be synthetized via telomerization of DMAEMA in water or water/acetonitrile mixture since the telomerization reaction is in competition with the nucleophilic addition of thiol onto the monomer. Transfer constants for mercaptoethanol in benzene and acetonitrile were determined by Mayo's and O'Brien's methods. The transfer constant obtained in acetonitrile (0,6) was higher than that obtained in benzene. This difference can be explained by the fact that the thiol was consumed by two reactions: nucleophilic addition and telomerization. The influence of solvents on the polymerization kinetics was enlightened. These results were applied to the synthesis of macromonomers of DMAEMA with isocyanatoethyl methacrylate (IEM). These macromonomers were copolymerized with styrene.     

Effect of dispersity on the Tll (>Tg) transition in polystyrene

The presence of a high temperature (>T_g) relaxation in amorphous polystyrene has been investigated further. In the previous work,¹ the techniques of differential thermal analysis (DTA) and torsional braid analysis (TBA) were employed to study polystyrene as a function of “monodisperse” molecular weight. The occurrence of the T_ll transition appeared to be associated with the attainment of a critical viscosity level with also corresponded with a free volume level. An entanglement network developed at a critical value of molecular weight, M_c, giving a break in the T_ll-versus-M plots. The present work deals with the influence of dispersity on the T_ll transition, below and above M_c. A series of binary blends of “monodisperse” anionically polymerized polystyrenes with systematic changes in M?_n and heterogeneity index (M?_w/M?_n) was tested by TBA. The results show that when both components have molecular weights below M_c, single and average values of T_g and T_ll are observed which are linearly related to M?_n^?1, as predicted by free volume arguments. Although a single T_g is observed when one component has a molecular weight above and the other has a molecular weight below M_c, the components appear to undergo the T_ll relaxation independently. The results indicate that both the glass transition and the T_ll transition are basically governed by the same type of molecular motion but at different length ranges.     

Dynamic mechanical analysis of polymers in the liquid state: Use of a perforated shim stock support

This report summarizes some initial results on the use of a perforated brass shim stock support to extend the useful range of dynamic mechanical testing well over 100 degrees above the traditional limiting polymer softening points of T_g or T_m. Weak secondary relaxations were observed above T_g in both polyisobutylene (PIB) and polystyrene (PS) homopolymer, copolymer, and blend systems and above T_m in gutta percha (trans-polyisoprene). The DuPont 981 Dynamic Mechanical Analyzer (DMA)–990 Thermal Analyzer system was used to characterize these weak liquid state processes. The DMA instrument deforms the specimen in flexure, thus minimizing the shear component present in some other techniques. Specimen-coating weights are typically in the range 20–40 mg. The perforations are particularly useful for polymers having low inherent adhesion to metals or systems which are very brittle in the glassy state, e.g., low MW PS's and many methacrylates.     

Thermomechanical analysis of Tg and T > Tg transitions in polystyrene

Phenomenological softening points were measured on a series of 13 anionic, nearly monodisperse, atactic polystyrenes using a DuPont 943 thermomechanical analyzer (TMA) in a penetration mode. Although TMA cannot identify the nature of the “transition” observed as such, the results obtained support the evidence for the T_g, T_ll, and T′_ll transition in polystyrene discussed in recent literature. T_g and T_ll were found to vary with molecular weight in a systematic manner, while T′_ll could only be observed at very high molecular weight. The technique appears to be quite useful in offering rapid and reproducible information on the various transitions in the liquid state of polystyrene.     

Technology transfer in digital mammography. Report of the Joint National Cancer Institute-National Aeronautics and Space Administration workshop of May 19-20, 1993

Digital mammography is one of the most promising novel technologies for further improvement of early detection of breast cancer, offering important potential advantages: 1) improved image quality; 2) digital image processing for improved lesion contrast; 3) computer-aided diagnosis for enhanced radiologic interpretation; and 4) teleradiology for facilitated radiologic consultation. The Diagnostic Imaging Research Branch of the National Cancer Institute (NCI) recently funded an international, multidisciplinary, multi-institutional Digital Mammography Development Group for collaborations between NCI, the academic community, and industry to facilitate the integrated development and implementation of digital mammographic systems. Currently, however, digital mammography faces a number of fundamental technological roadblocks: 1) cost-effective digital detectors and displays for imaging systems; 2) the need for novel algorithms for image processing and computer-aided diagnosis; and 3) high performance, low cost digital networks to provide an "information superhighway" for teleradiology. To solve some of these technological problems, the Diagnostic Imaging Research Branch of NCI joined efforts with the Technology Transfer Division of the National Aeronautics and Space Administration to pursue a federal technology transfer program in digital mammography. The authors discuss the findings and recommendations of the workshop entitled "Technology Transfer in Digital Mammography," which was organized and held jointly by the NCI and the National Aeronautics and Space Administration in May, 1993. Numerous innovative technologies of varying degree of promise for digital mammography were presented at the conference. In this article, specific technologies presented at the workshop by the federal and federally-supported laboratories are described, and critiques of these technologies by the leaders of the medical imaging community are presented.     

Neurorehabilitation/geriatric rehabilitation--goals achieved and aims from the viewpoint of the so-called "Vorarlberg Model"

Together with building up a first neurological department in one of the Austrian states we could introduce and organize the 1st scientific institute in literature for neuro-rehabilitation and -prophylaxis. 80% of the neuro-rehabilitation-patients are geriatrics. Hence overlapping of neuro-rehabilitation with rehabilitation in old age is to be postulated. "Rehabilitation of old age groups" as well has been named by us for the 1st time in scientific literature. Moreover we operate such activities on a large scale within a practical and social medical context. As worldover (at least within the civilized countries of high standards) the problem of old age groups is a steadily increasing and important, we are working on a very important scientific sector. Our slogan: "Holistic and permanent" is practically operated as follows: 1. Fluent transition of rehabilitation-adequate acute treatment towards a systematic specialized rehabilitation. 2. Schooling of relatives and follow up rehabilitation service. 3. Introducing rehabilitative thoughts as well in university, teaching as (by separate schoolings) within medical profession and all the other health professions. 4. We emphasize a plurality of methods; to be named here as main examples: integrated physiotherapy as well as integrated psychotherapy. Emphasizing more scientific values for (high age-)rehabilitation, we emphasize as well that it must not be banned into "high age ghettos". Contrarely rehabilitation adapted thinking must be integrated within all the health professions. 5. Innovation, phantasy and pleasure must be introduced into our work. We report of work with lay-groups, animal-visits, hippo-therapy, music, etc. This forms a large interesting territory for an upraising young generation in health professions.