Terminally ill patients and volunteer support: Is it the right intervention?

Comments on the article by K. T. Herbst-Damm and J. A. Kulik (see record 2005-02260-012) entitled Volunteer support, marital status, and the survival times of terminally ill patients. Can a simple and low-cost intervention, such as a visit by a volunteer, extend the life of terminally ill patients? The answer, according to a study by Herbst-Damm and Kulik (2005), is yes. When it comes to quality of life, however, the effects of volunteer visits remain murky. Thus, it is critical that we look beyond effects on longevity and assess how such a program would influence quality of life. Extending the life of terminally ill patients might not always a blessing. Prolonging their life might even cause harm, as it can extend unwanted physical and mental suffering. It may also go against some patients' desire to hasten their death. Despite Herbst-Damm and Kulik's important findings, the current author remains unconvinced as to the merits of implementing volunteer visits as an intervention policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of process concurrency on project outcomes in productdevelopment: an empirical study of cross-functional teams

This study examines the practice of concurrent engineering (CE) in terms of process concurrency, and the impact of concurrency on success of product development projects. The study is based on 50 cross-national projects from companies in Australia, Canada, Denmark, Finland, United Kingdom, and the United States in the aerospace, automobile, chemical, computer, electronics, shipbuilding, and telecommunications industries. Four dimensions of process and behaviors of engineering/R&D and manufacturing members of cross-functional product development teams were reliably operationalized: (1) two-way communication, (2) overlapping problem solving, (3) readiness to make decisions on the basis of uncertain and ambiguous information, and (4) readiness to release uncertain and ambiguous information. These dimensions of process concurrency were found to be reliable predictors of development projects' success, as measured by product cost and quality, project schedule and budget performance, and project team satisfaction. The paper offers implications for theory and practice and models of CE management for future research     

Young low responders protected from untoward effects of reduced ovarian response

OBJECTIVE(S): To correlate fertilization and clinical pregnancy rates (PRs) in low responders with their E2 levels (<500, 500-800, >800-1,000 pg/mL), age (20-30, 31-40, >40 years), number of follicles, and number of oocytes retrieved. DESIGN: A retrospective study. SETTING: The IVF unit of an academic hospital. PATIENT(S): One hundred forty-three women who failed to attain E2 levels of 1,000 pg/mL on the day of hCG administration. INTERVENTION(S): Controlled ovarian hyperstimulation, blood E2 and progesterone measurements, ultrasonographic scanning of ovarian follicles, oocyte retrieval after hCG administration, and ET. MAIN OUTCOME MEASURE: Clinical PR. RESULT(S): Although E2 levels, fertilization rates, age, and number of oocytes did not differ significantly between the three age groups, the PR achieved in the youngest group was approximately three times as high (19.3%) as that achieved in the two older groups. CONCLUSION: Young low responders represent a unique subset in that their age protects them from the deleterious effects of poor ovarian response.     

Role of orlistat in the treatment of obese patients with type 2 diabetes. A 1-year randomized double-blind study

OBJECTIVE: Obesity is an important risk factor for type 2 diabetes. Weight loss in patients with type 2 diabetes is associated with improved glycemic control and reduced cardiovascular disease risk factors, but weight loss is notably difficult to achieve and sustain with caloric restriction and exercise. The purpose of this study was to assess the impact of treatment with orlistat, a pancreatic lipase inhibitor, on weight loss, glycemic control, and serum lipid levels in obese patients with type 2 diabetes on sulfonylurea medications. RESEARCH DESIGN AND METHODS: In a multicenter 57-week randomized double-blind placebo-controlled study, 120 mg orlistat or placebo was administered orally three times a day with a mildly hypocaloric diet to 391 obese men and women with type 2 diabetes who were aged > 18 years, had a BMI of 28-40 kg/m2, and were clinically stable on oral sulfonylureas. Changes in body weight, glycemic control, lipid levels, and drug tolerability were measured. RESULTS: After 1 year of treatment, the orlistat group lost 6.2 +/- 0.45% (mean +/- SEM) of initial body weight vs. 4.3 +/- 0.49% in the placebo group (P < 0.001). Twice as many patients receiving orlistat (49 vs. 23%) lost > or = 5% of initial body weight (P < 0.001). Orlistat treatment plus diet compared with placebo plus diet was associated with significant improvement in glycemic control, as reflected in decreases in HbA1c (P < 0.001) and fasting plasma glucose (P < 0.001) and in dosage reductions of oral sulfonylurea medication (P < 0.01). Orlistat therapy also resulted in significantly greater improvements than placebo in several lipid parameters, namely, greater reductions in total cholesterol, (P < 0.001), LDL cholesterol (P < 0.001), triglycerides (P < 0.05), apolipoprotein B (P < 0.001), and the LDL-to-HDL cholesterol ratio (P < 0.001). Mild to moderate and transient gastrointestinal events were reported with orlistat therapy, although their association with study withdrawal was low. Fat-soluble vitamin levels generally remained within the reference range, and vitamin supplementation was required in only a few patients. CONCLUSIONS: Orlistat is an effective treatment modality in obese patients with type 2 diabetes with respect to clinically meaningful weight loss and maintenance of weight loss, improved glycemic control, and improved lipid profile.     

Exploring the conformational space of cyclic peptides by a stochastic search method

A stochastic search algorithm is applied in order to probe the conformations of cyclic peptides. The search is conducted in two stages. In the first stage, random conformations are generated and evaluated by a penalty function for ring closure ability, following a stepwise construction of each amino acid into the peptide by a random choice of one of its allowed conformations. The allowed conformational ranges of backbone dihedral angles for each amino acid have been extracted from a Data Bank of diverse proteins. Values of dihedral angles that do not contribute favorably to the scoring of ring closure are retained or discarded by a statistical test. Values are discarded up to a point from which all remaining combinations of angles are constructed, scored, sorted, and clustered. In the second stage, side chains have been added and fast optimization was applied to the set of diverse conformations in a "united atoms" approach, with the "Kollman forcefield" of Sybyl 6.8. This iterative stochastic elimination algorithm finds the global minimum and most of the best results, when compared to a full exhaustive search in appropriately sized problems. In larger problems, we compare the results to experimental structures. The root mean square deviation (RMSD) of our best results compared to crystal structures of cyclic peptides with sizes from 4 to 15 amino acids are mostly below 1.0 A up to 8 mers and under 2.0 A for larger cyclic peptides.     

Factor analysis of the Attitudes Toward Disabled Persons Scale—Form A.

Factor analysis of the attitudes of 133 rehabilitation and agency practitioners and trainees yielded four major factors: Coping-Succumbing, Emotional Need-Emotional Satisfaction, Sensitivity-Self-Consciousness, and Inferred Morality. The findings of this study are compared and contrasted with findings using similar instruments with different populations so as to explore psychometric issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The roles of group supervision of supervision.

This article recommends that group supervision of supervision be an integral part of the curriculum of any senior professional who is involved in regular supervision of trainees. Work in the group setting enables use of group dynamics to understand therapeutic events as well as processes of mirroring and identification in the supervision. The supervisory group may promote feelings of security and containment in the supervisors while attenuating and minimizing their potential feelings of vulnerability and validating their perceptions of reality. At the same time, such a group gives rise to difficulties (owing to issues of trust and confidentiality) both inside and outside the group (e.g., among trainees who develop fantasies about the proceedings of the group). Some general resolution of such problems is presented here. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ingres and photographic vision

Abstract

The initial impact of photography on painting and the continuing interplay between the two remain one of the intriguing questions confronting the historian of nineteenth century art. Recognition of photographic history as a significant discipline in its own right has grown. rapidly in the last four decades, but a great deal remains to be done on the connection between the two arts. The pioneering works of Newhall, Schwarz and, later, Scharf, Coke and others, have already focused attention on the way in which photography acted upon the style and content of painting, a matter now widely recognized among art historians. There is no longer any novelty or surprise in discovering that a prominent artist made reference to, or in some cases actually copied, a specific photograph. The student today accepts the fact that such artists as Delacroix, Courbet, Manet and Degas made use of the works of Durieu, Villeneuve, Nadar, Carjat, Disdéri and others.     

Israeli psychotherapists' reactions and perceptions on the process of psychotherapy during the Gulf War.

64 26–56 yr old psychotherapists (38 still in training), who practiced in areas that were either directly or indirectly threatened by missile attack during the Persian Gulf War, completed a questionnaire addressing well-being as affected by the war, the similarity between the patient's and the therapist's experience of the war, and how psychotherapists perceived the overall functioning of their patients and the extent that their internal conflicts were affected by the war. Therapists more directly threatened by the war reported having a greater positive mood than did Ss more indirectly threatened. Experienced psychotherapists addressed the war to a greater degree during the therapeutic hour; inexperienced Ss reported a greater change in their therapeutic stance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)