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Biomedical subjects

R Lasky

Publications and source records attributed to R Lasky.

18 recordsLinked to original sources
PubMed2000

Body ego and the preoedipal roots of feminine gender identity.

Traditionally, visual cues (that is, seeing the difference between one's own genitals and those of the opposite sex) and the fantasies that they prompt were thought to be the central determinants in the organization of gender identity. More recently attention has been focused on mother-infant interaction patterns, on the construction of the body itself, on its kinesthetic sensations, and on the fantasies that these evoke. These matters are now thought to be equal in importance to the traditional considerations. The resulting concept of a core gender identity has suggested the possibility of various forms of preoedipal genital anxiety. This paper discusses how two experiences common to childhood as well as adulthood--the tumescence of erectile tissue and the involuntary vaginal secretions of sexual arousal--may contribute to the organization of feminine gender identity. Case material, including a close examination of an analytic hour, is presented to show how this process may manifest itself in adult neurotic conflict.

Adult↗
PubMed1992

Distortion-product otoacoustic emissions in human newborns and adults.

Cubic distortion-product otoacoustic emissions (DPEs) may have clinical and research applications. We reliably recorded DPEs at some frequencies in all of the normal-hearing human adults and newborns tested. Adult and newborn DPEs were of comparable amplitude, with the exception that a prominent dip between 1 and 3 kHz in the adult data was less evident in the newborn data. DPE amplitude was a linear function of the intensity of the eliciting primary stimuli. The slopes of the linear input-output functions increased with increasing frequency. Except at the highest frequencies assessed, adult input-output functions were steeper than newborn input-output functions.

Acoustic Stimulation↗
PubMed1992

Some superego conflicts in the analyst who has suffered a catastrophic illness.

This paper, originally part of a panel (in a somewhat different form) on life stresses of the analyst, focuses on some of the superego conflicts of the analyst who has suffered a catastrophic illness. The interplay between ego and superego functioning is examined, particularly in reference to how superego conflicts cause the ego to become subordinated to drive-related aims and to superego demands from which it would ordinarily have more autonomous distance. Some of the issues which are conflictual for analysts who have suffered a catastrophic illness and which have a tendency to be played-out in the treatment include: problems of self-esteem regulation; regressive alteration of identifications; reinstinctualization of identifications and of object relations; alterations in the ego-ideal; disruptions of other narcissistic regulatory processes; and the above mentioned subordination of ego functions, especially in regard to its synthetic, reality testing, and other autonomous capacities. Examples are presented of how these conflicts may be dynamically operative in unconsciousness, how they may enter into consciousness, and how they might be expressed in the treatment.

Aggression↗
PubMed1991

Intraobserver and interobserver reliability in assessment of neonatal cranial ultrasounds.

Intraobserver and interobserver reliability in assessing neonatal cranial ultrasounds for periventricular-intraventricular hemorrhage (PVH-IVH) is not well studied; therefore, studies were designed to address this. For intraobserver reliability 180 cranial ultrasounds (360 hemispheres) were randomly selected from greater than 2000 ultrasounds and read twice by one radiologist in a blinded fashion. Ninety-eight percent were interpreted identically; of the 2% reinterpreted differently, all were initially abnormal but normal on the second reading. The least agreement occurred when interpreting ventricular size. Only four infants (1.1%) were placed in an unfavorable prognostic category (grades III and IV) on the first reading and a favorable prognostic category on the second interpretation (no bleed, grades I and II). To determine interobserver reliability, 20 sonograms were interpreted by eight independent observers representing five institutions. Using the multiple rater kappa kappa statistic, we determined interobserver agreement on overall impression (normal vs. abnormal), presence and extent of PVH-IVH (i.e. grade), presence of residual cyst, and ventricular dilatation. Greatest degree of agreement occurred when determining normal vs. abnormal, residual cyst, no bleed, and grades III and IV PVH-IVH. Poorest agreement occurred when reading grades I and II PVH-IVH and ventricular dilatation. After condensing interpretations of cranial ultrasounds into two prognostic categories, i.e. favorable (no bleed, grades I and II) and unfavorable (grades III and IV), there was excellent agreement among the observers.

Cerebral Hemorrhage↗
PubMed1990

Catastrophic illness in the analyst and the analyst's emotional reactions to it.

The author reviews the fact that there is very little literature available on catastrophic illness in the analyst and the analyst's emotional reactions to it, compared with other topics of interest. Some of the factors suggested to account for this are exhibitionistic concerns, concerns about one's privacy (including psychic privacy), embarrassment related to countertransference, and concerns about losses of referrals if colleagues perceive the analyst to be impaired. The author then draws a distinction between the emotional life of analysts and countertransference, and discusses how and why he defines them differently. The major part of the paper then goes on to discuss two major technical questions in considerable detail: (a) whether or not to give factual information to patients about one's condition, and (b) the manner in which the material is introduced into the analysis. A number of case examples are cited. The author closes with a discussion of the question of the pros and cons of reporting on the experience immediately versus waiting for the passage of time.

Adaptation, Psychological↗
PubMed1990

Prenatal care evaluation and cohort analyses.

The value of prenatal care has been obscured by multiple factors, including the limitations of birth certificate data, large socioeconomic disparities between women who seek prenatal care and those who do not, and the "preterm delivery bias", ie, the reduced pregnancy duration and opportunity for prenatal care among women who give birth prematurely. Perinatal mortality and morbidity (neonatal intensive care unit admission; ventilator therapy) were carefully assessed in an indigent population (28,838 deliveries at Parkland Memorial Hospital). To avoid the preterm delivery bias, a cohort of all women whose pregnancy reached a specific week of gestation was identified and their prenatal care status (zero vs one or more visits) by that week was related to pregnancy outcome. Separate cohorts were defined at 26, 30, 34, 38, and 42 weeks. Prenatal care was associated with improved pregnancy outcomes in only the 34-, 38-, and 42-week cohorts (P less than .01). Findings suggest substantial benefit from prenatal care after 30 weeks' gestation but not from early prenatal care. Unfortunately, it may not be possible to assess prenatal care accurately in observational studies even if cohort analyses are used. Clinical trials are needed to assess the effects of strategies for increasing or improving prenatal care, especially in early pregnancy.

Adolescent↗
PubMed1989

Randomized trial of taurine supplementation for infants less than or equal to 1,300-gram birth weight: effect on auditory brainstem-evoked responses.

Taurine may be important to the developing eye and brain of the small preterm infant. A blinded randomized trial was conducted to determine whether taurine supplementation of healthy infants of less than or equal to 1,300 g birth weight until their discharge from the hospital increases their growth rate, neurobehavioral development, electroretinographic development, or maturation of auditory brainstem-evoked responses. Infants were fed with Similac Special Care as desired, which was prepared to contain less than 5 mg/L of taurine or 45 mg/L of taurine, a concentration similar to that of human milk. Infants who did not receive taurine supplementation (n = 19) and those who did (n = 18) were similar with respect to condition at study entry, caloric intake, and growth rates throughout the study, and electroretinographic findings and scores on the Brazelton Behavioral Assessment Scale at 37 weeks' postmenstrual age. Infants who received taurine supplementation had greater overall plasma taurine concentrations. The group receiving taurine supplementation also had more mature auditory-evoked responses at 37 weeks' postmenstrual age with a modest (0.2 to 0.5 ms) but consistent reduction (P less than .05) in the interval between stimulus and response at two different stimulation rates. Although further study is needed, taurine intake appears to influence auditory system maturation of preterm infants.

Amino Acids↗
PubMed1989

More on taurine.

Explore the source record for details and available documents.

Drug Evaluation↗
PubMed1989

Some determinants of the male analyst's capacity to identify with female patients.

This paper reviews some recent literature on gender issues in the analytic dyad, and then focuses specifically on the male analyst-female patient dyad. In order for male analysts to work effectively with female patients they must be able to identify with feminine concerns and dynamics. The paper discusses the male analyst's attempts to master castration anxieties, provoked by such identifications, in order to permit his female patients' concerns to resonate within him. He uses early maternal identifications in working with the pre-phallic material of his female patients, and he uses less readily neutralized direct identifications with his mother (and other women) to address his female patients' phallic concerns. The importance of resolving conflicts around the organization of a stable and mature masculine identity in his training analysis is emphasized, since the male analyst's freedom to use feminine identifications constructively in his work is dependent on it.

Anxiety, Castration↗
PubMed1984

Effect of nursing-staff support groups on the quality of newborn intensive care.

ICU support groups are widely recommended to mitigate the effects of stress on staff performance, thereby improving patient care. The usefulness of a nursing-staff support group was assessed in the neonatal ICUs of both a city/county hospital (10,000 births/yr) and a private hospital (3200 births/yr). Support-group meetings focused on communication and patient care and were conducted every 1 to 2 wk by psychiatrists experienced in intensive care support groups. Nevertheless, attendance diminished and the groups lasted only 6 to 7 months. Moreover, the quality of routine, emergency, and overall care did not differ significantly during intervention vs. control months. Our findings suggest that sources of ICU stress may be best addressed by methods other than nursing-staff support groups. Under the conditions of the study, we found little evidence to justify the expense and effort required to conduct ICU support groups.

Crisis Intervention↗
PubMed1976

Effects of maternal nutrition on fetal growth and infant development.

The results of a food supplementation study conducted in four chronically malnourished rural villages in Guatemala were analyzed to determine possible effects on the study children's early mental and physical development. One of two food supplements, atole and fresco, were given to pregnant and lactating mothers and the infants born to them up to three years of age. The level of supplement received was noted and the subsequent course of the children's development observed. Food supplementation of pregnant mothers was found to correlate with higher weights of their babies at birth. No other major maternal variables--home diet, body height and/or weight, morbidity, obstetric characteristics, or socioeconomic status--could account for this association. At 36 months of age the children who had received a large amount of food supplementation showed a far lower prevalence of growth retardation than did those who received smaller quantities. Again, this correlation could not be attributed to any other major maternal variables. In regard to mental development, food supplementation was found to correlate with better performance in psychological tests beginning at six months of age. At 36 months the correlations were significant in five different tests. The results of this analysis have wide-ranging implications for public health. Given the recognized association between low birthweight and infant mortality, they point especially to the importance of maternal nutrition during pregnancy in programs aimed at reducing this serious problem.

Child, Preschool↗