The effect of dietary fiber in tube-fed elderly patients

Diarrhea is a common problem with potentially serious consequences for elderly tube-fed patients. A review of the literature indicates that diarrhea has been associated with the use of antibiotics, low blood albumin concentration, and a lack of fiber in the diet. This study documents the observed effect of dietary fiber on the incidence of diarrhea in 50 tube-fed patients. Over a 3-week period, patients who received fiber-containing formula had fewer liquid/loose stools than patients who received fiber-free formula. Nurses who care for elderly, tube-fed patients can help to improve outcomes by advocacy and interdisciplinary collaboration with registered dietitians and primary providers and by teaching assistive staff the importance of accurate recording of bowel function.     

Pathological narcissism in an eight-year-old boy: An example of Bellak's TAT and CAT diagnostic system.

Presents the Children's Apperception Test (CAT) protocol of an 8-yr-old boy with narcissistic pathology and demonstrates the approach of L. Bellak (1986) in making this assessment. Bellak provided an analysis of the relation of the ego (self-concept characteristics of the main hero, conception of the world, interpersonal object relations, defense mechanisms, and 12 ego functions), id (thematic analysis, needs, anxieties, and significant conflicts), and superego. A summary of the CAT results and treatment recommendations are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Calcium and magnesium balance in 9-14-y-old children

Few data are available regarding calcium and magnesium absorption and endogenous fecal excretion in children. We used a multitracer stable isotope technique to assess calcium and magnesium balance in 12 boys and 13 girls aged 9-14 y (mean weight: 42 kg) maintained on relatively high calcium intakes (mean: 1310 +/- 82 mg/d). There were no significant differences in absorption of calcium or magnesium from milk between boys and girls. Calcium retention (balance) correlated positively with calcidiol (25-hydroxyvitamin D) concentration (r = 0.48, P = 0.02) and serum alkaline phosphatase activity (r = 0.44, P = 0.03). There was no significant relation between magnesium balance and concentration. When data from this study were combined with our previously reported data, an increase in total calcium absorption was seen for pubertal (Tanner stages 2-4) but not prepubertal (Tanner stage 1) white children over the range of intakes from approximately 750 to 1350 mg/d. Despite intakes similar to the 1989 recommended dietary allowance for magnesium (mean intake: 6.4 +/- 1.2 mg.kg-1.d-1), 11 of the 25 subjects (6 girls and 5 boys) were in negative magnesium balance. We conclude that benefits from higher calcium intakes, < or = 1350 mg/d, were most apparent in pubertal children. In addiction, higher magnesium intakes should be considered for children.     

Long-term semantic memory versus contextual memory in unconscious number processing.

Subjects classified visible 2-digit numbers as larger or smaller than 55. Target numbers were preceded by masked 2-digit primes that were either congruent (same relation to 55) or incongruent. Experiments 1 and 2 showed prime congruency effects for stimuli never included in the set of classified visible targets, indicating subliminal priming based on long-term semantic memory. Experiments 2 and 3 went further to demonstrate paradoxical unconscious priming effects resulting from task context. For example, after repeated practice classifying 73 as larger than 55, the novel masked prime 37 paradoxically facilitated the "larger" response. In these experiments task context could induce subjects to unconsciously process only the leftmost masked prime digit, only the rightmost digit, or both independently. Across 3 experiments, subliminal priming was governed by both task context and long-term semantic memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is histological examination of tissue removed by general practitioners always necessary? Before and after comparison of detection rates of serious skin lesions

OBJECTIVES: To examine whether histological examination of all tissue removed by general practitioners in minor surgery increases the rate of detection of clinically important skin lesions, and to assess the impact of such a policy on pathologists' workload. DESIGN: Before and after comparison. SETTING: Stratified random sample of 257 general practitioner partnerships from the catchment areas of 19 English pathology laboratories. SUBJECTS: Tissue removed in minor surgery by general practitioners during the control period (September 1992 to February 1993) and intervention period (September 1993 to February 1994). INTERVENTION: General practitioners referred to their local pathology laboratory all solid tissue removed in all minor surgery, irrespective of their previous policy. MAIN OUTCOME MEASURES: Numbers of specimens referred for histology by general practitioners during intervention and control periods; numbers of primary malignant melanomas, non-melanoma malignancies, premalignant lesions, and benign lesions. RESULTS: 257/330 partnerships participated (response rate 78%). During the intervention period 5723 specimens were sent, compared with 4430 during the control period. The referral rate increased by an estimated 1.34 specimens per 1000 patient years (95% confidence interval 0.93 to 1.76, P < 0.0001). General practitioners sent 204 specimens that were malignant (including 16 malignant melanomas) in the control period and 188 that were malignant (including 15 malignant melanomas) during the intervention period (change in total number of malignancies, -1.0 per 100,000 patient years (-5.9 to 3.8, non-significant). CONCLUSIONS: The intervention was associated with a substantial increase in laboratory workload, all of which was accounted for by increases in non-serious lesions. This observation should be taken into account when considering the merits of a policy requiring histological examination in every case.     

Coordinating developmental and psychoanalytic processes: conceptualizing technique

Throughout childhood and adolescence, psychological growth proceeds in a sequence of progressive hierarchical organizations. Consequently, children are continuously consolidating existing positions or are in transition from one to another. When analytic treatment is proposed, analysts often find themselves in the position of being required to technically coordinate the requirements of the analytic process with those of the ongoing developmental process. While it is the patient who will ultimately bring the needs of both processes together, the approach the analyst assumes to recognizing and addressing these needs can have a facilitating influence on the treatment. Play, for example, is a window on old conflicts and impaired object relationships from the past, but it is also a way in which children consolidate existing organizational hierarchies. Similarly, the analytic interaction provides a pathway to the past, but it is also used by children to provide the building blocks for newly emerging structures. To facilitate further clinical research, a conceptual outline of the relationship between the two processes is provided.     

The effect of antimony oxide flame retardants on color of vinyl films

The scattering power, or whiteness of antimony oxide varies directly with particle size. In extremely small particle sizes, when scattering power is low, the film is quite transparent. As particle size increases, scattering power increases to a maximum, somewhere between 0.2 and 1.0 micrometer, drops off again with increasing particle size. In white and pastel film, a high-scattering grade will supplement the major pigment. In dark and deep colors, use of a more transparent grade, even one at a premium price, may prove more economical, since pigment loading may be reduced.     

Phonologically Mediated Priming of Preexisting and New Associations in Young and Older Adults.

In 2 experiments, the authors investigated phonologically mediated priming of preexisting and new associations in word retrieval. Young and older adults completed paired word stems with the first word that came to mind. Priming of preexisting associations occurred when word-stem pairs containing homophones (e.g., beech-s____) showed more completions with the target (e.g., sand) relative to unrelated pairs (e.g., batch-s____), with more priming for subordinate than for dominant homophones. Priming occurred for new associations independent of dominance such that word-stem pairs containing homophones (e.g., beech-l____ and beach-l____) were completed with the same word (e.g., laugh) more often than unrelated pairs (e.g., beech-l____ and batch-l____). No age differences in phonologically mediated priming were found for either type of association, suggesting age equivalence in the use of bottom-up phonological connections. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multicenter trial of fluoxetine as an adjunct to behavioral smoking cessation treatment.

The authors evaluated the efficacy of fluoxetine hydrochloride (Prozac; Eli Lilly and Company, Indianapolis, IN) as an adjunct to behavioral treatment for smoking cessation. Sixteen sites randomized 989 smokers to 3 dose conditions: 10 weeks of placebo, 30 mg, or 60 mg fluoxetine per day. Smokers received 9 sessions of individualized cognitive-behavioral therapy, and biologically verified 7-day self-reported abstinence follow-ups were conducted at 1, 3, and 6 months posttreatment. Analyses assuming missing data counted as smoking observed no treatment difference in outcomes. Pattern-mixture analysis that estimates treatment effects in the presence of missing data observed enhanced quit rates associated with both the 60-mg and 30-mg doses. Results support a modest, short-term effect of fluoxetine on smoking cessation and consideration of alternative models for handling missing data. (PsycINFO Database Record (c) 2010 APA, all rights reserved)