Practicum students' verbal responses to different clients.

Studied 24 counselor trainees' verbal behavior in 2 initial interview settings, one each with an active and a passive client. Using E. J. Amidon's classification system for verbal behavior of counselors, a trained O recorded 7 categories of indirect influence behavior (e.g., trainee accepting or clarifying feelings), 3 categories of direct influence behavior (e.g., trainee giving directions) during 3-6 sec units of verbal interaction. Client type was developed from a system of mild pathology. When trainees engaged different client types, verbal interaction differed significantly in 5 of 7 categories describing trainee talk, in total trainee talk, in trainee direct and indirect influence, in total and kind of client talk, and in silence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postextrasystolic potentiation and dobutamine echocardiography in predicting recovery of myocardial function after coronary bypass revascularization

BACKGROUND: Identification of viable but hibernating myocardium remains a relevant issue in the current era of myocardial revascularization. Echocardiography can be helpful in detecting reversible contractile dysfunction and optimizing the selection of patients for coronary bypass surgery. METHODS AND RESULTS: Eighty-four consecutive candidates for bypass surgery with chronic multivessel coronary artery disease were screened, and 60 were included in this prospective study. Preoperative evaluation of a reversible contractile dysfunction in asynergic myocardial regions was performed by dobutamine infusion at 5 (low dose) and 10 (intermediate dose) microg x kg(-1) x min(-1) with each stage lasting at least 5 minutes; postextrasystolic potentiation (PESP), with a coupling interval ranging from 500 to 300 ms with a progressive 10-ms decrease; or a combination of both dobutamine infusion and PESP. Sensitivity (92% versus 86%) and predictive accuracy (89% versus 84%) were higher with PESP than dobutamine (P=.009 and P=.001, respectively), but the combination did not improve sensitivity or accuracy. Dobutamine induced ischemic dysfunction in 15% of patients at the intermediate dose; however, the low dose resulted in loss of sensitivity. CONCLUSIONS: PESP echocardiography is a useful and cost-effective method to identify viable myocardium in patients with multivessel coronary disease undergoing revascularization and is more sensitive and accurate than dobutamine infusion.