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Biomedical subjects

E Nijenhuis

Publications and source records attributed to E Nijenhuis.

4 recordsLinked to original sources
PubMed2001

Effectiveness of couch height-based patient set-up and an off-line correction protocol in prostate cancer radiotherapy.

PURPOSE: To investigate set-up improvement caused by applying a couch height-based patient set-up method in combination with a technologist-driven off-line correction protocol in nonimmobilized radiotherapy of prostate patients. METHODS AND MATERIALS: A three-dimensional shrinking action level correction protocol is applied in two consecutive patient cohorts with different set-up methods: the traditional "laser set-up" group (n = 43) and the "couch height set-up" group (n = 112). For all directions, left-right, ventro-dorsal, and cranio-caudal, random and systematic set-up deviations were measured. RESULTS: The couch height set-up method improves the patient positioning compared to the laser set-up method. Without application of the correction protocol, both systematic and random errors reduced to 2.2-2.4 mm (1 SD) and 1.7-2.2 mm (1 SD), respectively. By using the correction protocol, systematic errors reduced further to 1.3-1.6 mm (1 SD). One-dimensional deviations were within 5 mm for >90% of the measured fractions. The required number of corrections per patient in the off-line correction protocol was reduced significantly during the course of treatment from 1.1 to 0.6 by the couch height set-up method. The treatment time was not prolonged by application of the correction protocol. CONCLUSIONS: The couch height set-up method improves the set-up significantly, especially in the ventro-dorsal direction. Combination of this set-up method with an off-line correction strategy, executed by technologists, reduces the number of set-up corrections required.

Humans↗
PubMed2001

Generalized dissociative amnesia: episodic, semantic and procedural memories lost and found.

OBJECTIVE: This review tests Ribot's classic twofold categorization of generalized amnesia (GA) into Type I, total loss of episodic memory, and Type II, additional more or less extensive loss of semantic and/or procedural memory. It also explores his law of regression, according to which, cast in modern terms, recovery of lost procedural and semantic memories precedes recovery of episodic memory, as well as reported aetiological factors. METHOD: Clinically and formally assessed cases of GA, published since 1845, were surveyed and further analysed. RESULTS: Over and above authentic episodic memory loss, cases differed widely in the extent of impairment of semantic and procedural memory. Recovery of semantic and procedural memory often preceded recovery of episodic memory. This particularly applied to authenticated trauma memories. To an extent, lost memories affected current functioning, and in some cases were associated with alternating dissociative personalities. Severe memory distortions upon memory recovery were not reported. Most cases were trauma or stress related, while in some cases the aetiology remained unknown. CONCLUSIONS: Contrary to the view expressed in DSM-IV, which states that dissociative amnesia pertains to an inability to recall personal information, GA may also involve loss and recovery of semantic and procedural memories. Since the loss of various memory types in GA is dimensional rather than categorical, Ribot's typological distinction does not hold. Some of the reviewed cases suggest a trauma-related aetiology. Generalized amnesia of varying degrees of severity can involve delayed retrieval of trauma memories, as well as the loss and delayed retrieval of the premorbid personality.

Amnesia↗
PubMed1995

"Experience-sharing" as an antidote to dependence-making behavior of general practitioners.

This article explores how group-dynamic interventions can be used to teach health professionals to counter impulses to make clients dependent on them. The basic assumption, derived from Kohut's work on narcissism, is that dependence-making behavior is connected with deep-rooted feelings of insufficiency resulting from a defective autonomy. A part of the standard Dutch General Practice (GP) training program, experience-sharing in groups of 12 GP trainees, offers opportunities to explore these feelings. The format of this experience-sharing (well-defined boundaries, minimal structure, facilitating leaders) often evokes behavior in which the peculiarities of the dependence-making behavior of the GP's vis-à-vis patients are mirrored: that is, dependent behavior. In order to analyze and influence this behavior, use can be made of Levine's model of group psychotherapy, which focuses on enhancing autonomy. In this paper we show, by means of four group cases, how Levine's framework can be used to enhance autonomy, lessen dependence, and thus diminish the tendency of GP's toward dependence-making behavior.

Dependency, Psychological↗