Biomedical subjects
Publications and source records attributed to H Harper.
Community mental health teams (CMHTs) are widely regarded as the mainstay of community services, bringing health and social services professionals together to target people with severe mental health problems. Heather Harper and Edana Minghella report the findings of a recent survey looking at the pressures and rewards of working in these community-based, multi-disciplinary teams.
BACKGROUND: Botulinum A exotoxin (BTX) has been used successfully to treat a variety of hyperkinetic movement disorders. BTX is also capable of reducing hyperkinetic facial lines including prominent glabellar frown lines. OBJECTIVE: The purposes of this study were to (1) confirm the efficacy of BTX in a double-blind, placebo-controlled investigation; (2) evaluate the use of an electromyogram attached to the injection needle to confirm intramuscular corrugator placement of the BTX; and (3) determine the optimum direction injection technique. METHODS: Length and depth of glabellar frown lines were measured before treatment and 4 and 12 weeks after injection of 10 units of BTX or saline solution. RESULTS: Patients treated with BTX had a highly significant reduction in depth and length of glabellar frown lines compared with control subjects. CONCLUSION: BTX appears to be effective and safe for reduction of glabellar frown lines.
A psychotherapist's verbal interventions may be understood as promoting a client's eventual improvement by facilitating developmental change processes within the client. This approach is an alternative to the traditional search for statistical links between aggregates of therapist interventions and global outcome measures. Our approach employs models of clients' assimilation of problematic experiences within problem domains and therapists' implementation of theoretically specified aims. In an empirical illustration, one client's change within a particular problem domain and its links with therapist interventions were assessed qualitatively across the course of brief psychodynamic-interpersonal treatment.
The selection of a case of demonstrated change using a quantitative criterion preceded an exploration of possible change mechanisms in therapy. Between-session variations in the therapeutic relationship revealed by a quantitative measure prompted an intensive qualitative investigation of in-session events. Within these events, the study focused on challenges to the therapeutic relationship and their subsequent resolution. Understanding the resolution of such challenges to the relationship was guided by a rational model derived from the treatment rationale. A tentative account of the process of change is offered, and case replications are required to confirm and extend the findings.
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BACKGROUND: It has been suggested that the principal mechanism of nystagmus suppression in the nystagmus blockage syndrome is either adduction of the eye or convergence. We examined this issue using the nystagmus of the vestibulo-ocular reflex (VOR) as a model. METHODS: A motorized, computer-controlled rotary chair was used to produce VOR in darkness, using either sinusoidal or velocity step stimulation. Left eye position was monitored and horizontal slow-phase eye velocity was calculated. Subjects were cued to converge or perform other gaze tasks. RESULTS: Convergence suppressed nystagmus. With sinusoidal stimulation, nystagmus was nearly extinguished in extreme lateroversion, probably due to mechanical tethering of the eye. However, VOR gain suppression of 47% during convergence was observed even when the monitored eye was close to primary position. With velocity step stimulation, nystagmus was nearly extinguished at moderate angles of adduction. CONCLUSIONS: Convergence is sufficient to suppress nystagmus, without vision and without regard to whether the eye is adducted.