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At least 433 records · Page 24Linked to original sources
PubMed2006

Are there relational disorders? A harmful dysfunction perspective: comment on the special section.

Can relational disorders exist as genuine medical disorders, even when there is no disorder in either individual participating in the relationship? Using the harmful dysfunction analysis of the concept of disorder as a framework, this comment on the special section on Relational Disorders (September 2006 issue of the Journal of Family Psychology) presents the argument that relational disorders do indeed exist. The harmful dysfunction analysis holds that disorders are harmful failures of biologically selected functions. The position argued for here is that there are evolutionarily selected functions that depend for their performance on the nature of the interaction between individuals and that these relational functions can fail, even when both individuals are normal, because of mismatches between normal variations. Thus, there are genuine relational dysfunctions that, when harmful, are relational disorders. Indeed, the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) currently misclassifies some sexual relational disorders as individual disorders.

Female↗
PubMed2006

You cannot choose what is not on the menu--obstacles to and reasons for the inclusion of relational processes in the DSM-V: comment on the special section.

Relational diagnosis has crucial importance in clinical treatment, but its development and inclusion in systems of classification such as the Diagnostic and Statistical Manual has been constrained by a number of factors. First, there is little consensus about what relational assessment and/or diagnosis entails. A second obstacle is the innate complexity of relational assessment and diagnosis, which results in a lack of definitive, well-accepted, evidence-based operational definitions of difficulties. Third, empirical testing of relational issues has lagged well behind the development of elegant theory. A fourth significant block to including relational disorders in the DSM is the discomfort engendered in some quarters about labeling social difficulties as disorders. Finally, the political process that is part of the evolution of diagnostic systems poses difficulties in the acceptance of new disorders or dimensions. This comment on the articles in the special section on relational disorders of the Journal of Family Psychology addresses how each of these articles contributes to overcoming these constraints.

Diagnostic and Statistical Manual of Mental Disord↗
PubMed1975

The applied communication game: a comment on Muma's "communication game: dump and play".

We now have technology available to teach speech and language skills to children. We cannot always expect children to carry over or generalize this training and spontaneously use this "trained language" in communication situations, so we now must develop technology for teaching interpersonal communication skills. This report commented on a model presented by Muma (1975). Illustrations were presented that should help clinicians train more effective interpersonal communication. The applied communication game provides an objective procedure that utilizes the natural consequences in communication situations to improve communication skill in handicapped children.

Child↗
PubMed1995

Responsiveness of male adolescents with mental retardation to input from nondisabled peers: the summoning power of comments, questions, and directive prompts.

The expressive communication of individuals with cognitive impairments may be directly influenced by a partner's input, because such individuals often have limited conversational skills. Sequential analyses of dyadic interactions examined the effects of input by 32 normally developing adolescents on responses by male subjects with mental retardation whose communication modes included augmented communication. Results suggested that (a) verbal prompts in the form of questions were significantly more likely to receive responses from subjects with mental retardation than directive prompts, (b) comments were significantly more likely to receive responses from subjects with retardation than were directive prompts, when the nondisabled peer was male, and (c) male subjects with mental retardation were more likely to respond to input from male peers than from females. These data suggest that questions facilitate naturally occurring conversations but underscore the importance of evaluating gender-related effects on interaction involving persons with severe cognitive and communication impairments.

Adolescent↗
PubMed1995

Brown-Séquard's comment on Du Bois-Reymond's "hemikrania sympathicotonica".

In 1859 the famous physiologist Du Bois-Reymond, a migraine sufferer, stated that migraine could be due to an increased sympathicotonic influence on the blood vessels of one side of the head. Migraine, he thought, was not a disease of the brain or cranial blood vessels, but of the cilio-spinal center in the spinal cord. The physician and physiologist Brown-Séqard, who, independently from Claude Bernard, discovered and interpreted the action of the vasomotor nerves in the early 1850s, commented on Du Bois-Reymond's paper, stating that irritation of the cervical sympathetic does not cause pain. From his great experience from animal experiments and clinical observations he had concluded that stimulation of the cervical sympathetic would cause epileptic seizures, rather than migraine attacks. He felt that Du Bois-Reymond's observations would better fit a sympathico-paralytic model of migraine. He was seconded by other physicians like Möllendorff, until Latham tried to unify both theories.

Brain↗
PubMed2003

Conceptualization and measurement of health-related quality of life: comments on an evolving field.

This article summarizes personal views on the rapidly evolving field of functional health assessment and comments on their implications for advances in assessment methods used in rehabilitation medicine. Topics of strategic importance included (1). a new formulation of the structure of health status designed to distinguish role participation from the physical and mental components of health for purposes of international studies; (2). applications of item response theory that offer advantages in constructing better functional health measures and cross-calibrating their underlying metrics; (3). computerized dynamic assessment technology, well proven in education and psychology, which may lead to more practical assessments and more precise score estimates across a wide range of functional health levels; and (4). intellectual property issues involved in standardizing and promoting readily available assessment tools, ensuring their scientific validity, and achieving the best possible partnership between the scientific community and those developing commercial applications. Promising results from preliminary attempts to standardize and improve the metrics of functional health assessment constitute grounds for optimism regarding their potential usefulness in rehabilitation medicine. Someday, all tools used to measure each functional health concept, including the best single-item measure and the most precise computerized dynamic health assessment, will be scored on the same metric and their results will be directly comparable. To achieve this goal in rehabilitation medicine, we have much work to do.

Activities of Daily Living↗
PubMed2001

[Advanced breast biopsy instrumentation (ABBI) experiences and critical comments].

UNLABELLED: Advanced breast biopsy instrumentation (ABBI) experiences and critical comments. PURPOSE: To describe our three-years' experience with advanced breast biopsy instrumentation (ABBI). MATERIALS AND METHODS: Considering lesion size, type and location as well as patient specific criteria 89 patients were selected for an ABBI. The documented data like duration, complication and change of the procedure, size of the lesions and biopsy cannulas, histologic outcome and further treatment were analysed retrospectively. RESULTS: ABBI was successful in 63 of 89 patients. Cancer was found in 18 patients (29 %) with a surgical re-excision to achieve tumour-free margins in 89 %. 45 patients had benign lesions (71 %) with a benign to malignant ratio of 2.5 : 1. ABBI was unsuccessful or had to be replaced by other biopsy techniques in 26 patients (29 %). In four of these patients the localization needle was already placed. Analysing the three-year period ABBI frequency dropped each year with an overall reduction of 63 %. Despite a good benign to malignant ratio the surgical re-excision rate in cancer patients is disappointing. Although using precise selection criteria for ABBI the rate of failed biopsies and changeover to another biopsy procedure was too high. The reduction of ABBI procedures during the three-year period is assumed to be an expression of the negative experiences with the method but also a refusal of the assigning colleagues to use ABBI. CONCLUSION: For the evaluation of suspected breast lesions ABBI is too invasive and too expensive. On the other hand ABBI is too ineffective as a therapeutic tool to remove suspected lesions. Therefore it is not warranted to use ABBI instead of other concurrent biopsy techniques.

Adult↗
PubMed1996

[Intubation damage to the larynx. Manifestations, comments on pathogenesis, treatment and prevention].

BACKGROUND: A variety of lesions can be seen in the larynx subsequent to an intubation anaesthesia or treatment with a respirator. The larynx may already be injured by introducing an endotracheal tube. The inserted tube must necessarily chafe the laryngeal mucosa. Many studies are concerned with individual manifestations [5-10,14,16,17,20]. The following article gives an overview of the intubation lesions of the larynx observed by us and offers comments on pathogenesis and prevention. PATIENTS: 161 patients with severe lesions subsequent to an intubation or treatment with a respirator were seen at the ENT Department of the University of Marburg Hospital from 1973 to 1995. TYPES OF LESIONS CAUSED BY INTUBATION: Basing on the pathomechanisms, we can classify the lesions as follows: inflammatory reactions, lesions of the larynx caused during intubation, lesions caused by chafing by the tube or by the sealing sleeve. CONCLUSIONS: Considering the large number of performed intubations, lesions of the larynx occur rarely. However, in view of the possible sequels, it would be advisable if an experienced laryngologist would perform a careful endoscopic examination of the larynx and trachea at least after every forced or prolonged intubation and especially after every treatment with a respirator.

Adolescent↗
PubMed1988

[Comments on the contribution: initial results of surgical treatment of scoliosis with the Cotrel and Dubousset CD instruments by Ch. Hopf, H. H. Matthiass and J. Heine. Z. Orthop. 125 (1987) 347].

It really must be appreciated that in the above mentioned publication of Hopf, Heine and Matthiass the authors were brave enough-against normal habits-to publish their bad results. In demonstrating their cases they render the CD system a destructive rebuff. Not in one of their demonstrated cases they were able to show that there are convincing advantages of this surgery compared to other already wellknown and sufficiently proven methods. We still have to acknowledge the opinion of Nachemson (1986) that the CD method is yet in the experimental stage. The authors show in their selective cases how it should not be done. They sacrifice in favor of a primary stability functionally important segments of the spine cranially as well as caudally and thus mutilate young human beings to an irresponsible extent. Of course it is astonishing when the authors in spite of their actually crushing experiments with this system in summary arrive at positive results without reasons indeed. For example they comment positively on the attained derotation, although they had shown with their results that no derotation could be achieved at all. Remarks about diminishing the rib hump, which should after all be a result of a good derotation are missing. Exact measurements in CT scans of the apical vertebra, as demonstrated in an extraordinary way by Giehl, have not yet been made in Münster. Otherwise the authors would have clearly recognized that a derotation with resection of the discs is not possible using the CD method. The authors present the system-in spite of their very bad results-as a universal spinal system for correction and stabilization and at the same time they doubt the value and extent of anterior surgical methods according to Dwyer or Zielke, even though these methods have internationally shown how the optimal corrections have resulted in fewer mutilations by using shorter fusion areas on the spine provided that the surgeon knows how to use the instruments. We spine surgeons should always be aware that we can cause an irreversible condition on the spine of the human being with our spinal fusion operation this could have grave results for the patient for his whole life. No doubt, there are advantages in the CD method, but they rather result in better stability than in better corrections.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1981

[Comments on classification and terminology of congenital malformations in lower arm and hand (author's transl)].

It is the aim of this paper to draw attention to the problems facing the clinician when he tries to find a suitable nomenclature and classification of congenital malformations of the forearm and hand. The classification presented here takes into consideration the so-called Paris Nomenclature of 1969, as well as the systematisation of limb defects of the Working Group of the International Society for Prosthetics and Orthetics (commented upon by Henkel and al 1979), as well as the systematic organisation of malformations of the forearm and hand by Müller (1937), Werthemann (1952), Hopf (1959) and Witt, Cotta, Jäger (1966). On no account may this be regarded as a rigid and final setup. Efforts to achieve greater precision are still under way as before, with special emphasis on significant information supplied by teratology, embryology, genetics and biochemistry.

Arm↗
PubMed2005

Comment on "First principles electrochemistry: electrons and protons reacting as independent ions" [J. Chem. Phys. 117, 10193 (2002)].

The entropy of the electron gas used by Llano and Eriksson (LE) in the definition they used for an absolute half-cell potential (AHCP) is indeterminate. This AHCP is therefore not based on a thermodynamically well-defined process and cannot easily be extended to other thermodynamic functions such as entropy. An alternative approach to the AHCP avoids these difficulties. The present comment also corrects statements and concepts presented by LE about the temperature coefficient of the Fermi level and surface charge of the electrolyte solution.

Journal Article↗
PubMedDate not supplied

Diagnostic markers for child speech-sound disorders: introductory comments.

The four papers in this issue report findings from a research programme on the etiological origins of child speech-sound disorders of currently unknown origin. Overviews elsewhere describe an evolving classificatory framework that posits six putative subtypes within this general domain of communicative disorders (cf. Shriberg, 2002). The following introductory comments provide brief historical and clinical perspectives on the primary objective of this research: the availability of a suite of computer-assisted diagnostic markers that clinicians and clinical researchers can use to classify six etiological subtypes of child speech-sound disorders.

Articulation Disorders↗
PubMed1995

Respiratory protection standard: comments on OSHA's proposed revision.

On November 15, 1994, the Occupational Safety and Health Administration (OSHA) published in the Federal Register (59:58884-58956) the draft of a proposed revision of the Respiratory Protection Standard. One of OSHA's oldest standards, the Respiratory Protection Standard defines the conduct of the employer (eg, hospital) with respect to respirator training, fit testing, medical examinations, use, storage, and so on. The proposed revision appears to have been drafted with no consideration for its effect on healthcare workers or the healthcare industry. SHEA has prepared the following comments to OSHA, which have been submitted to the docket and will be presented at public hearings later this month.

Guidelines as Topic↗
PubMed2003

Perceptions of "good palliative care" orders: a discursive study of cancer patients' comments.

Patients' perceptions regarding Good Palliative Care (GPC) orders, a form of advance directives, were sought, and issues inherent in their promotion as policy were identified. Semi-structured interviews with 23 oncology-clinic outpatients, focused on end-of-life decision making, were tape-recorded, transcribed, and analyzed using discursive-analytical techniques. Most patients were unfamiliar with the term GPC orders, preferring the familiar "do-not-resuscitate" orders. GPC orders were negatively perceived as vague, beyond the individual's control, implying dependency on others, and failing to reduce suffering. Positive perceptions of GPC orders saw them as counteracting the impersonality of medical procedure and asserting the value of the whole patient within a social context. Participants' comments on a draft copy of a GPC order form suggest that they view consultation as beneficial, but that a standardized form may be impersonal and inappropriate. The structure and content of the GPC order form constitute it as a quasilegal document that may confuse and disempower patients, and function to protect the interests of the medical profession in the guise of promoting patient autonomy. The potential benefits attributed to GPC orders are achievable without the adoption of a blanket policy that depersonalizes and bureaucratizes the dying process, and may be less than sensitive to individual patients' needs.

Advance Directives↗
PubMed2006

Comments from the Center for Biosecurity of UPMC on proposed revisions to federal quarantine rules.

On November 30, 2005, the U.S. Centers for Disease Control and Prevention (CDC) proposed changes to federal quarantine regulations (42 CFR Parts 70 and 71). As stated in the proposed rules, the intent of changes is "to clarify and strengthen existing procedures to enable CDC to respond more effectively to current and potential communicable disease threats." Parts 70 and 71 of 42 CFR authorize the Secretary of the Department of Health and Human Services (HHS) to make and enforce regulations "as in his judgement are necessary to prevent the introduction, transmission, and spread of communicable diseases" from foreign countries (Part 71) and between states (Part 70). The Center for Biosecurity of UPMC reviewed the proposed revisions to the quarantine regulations and submitted to CDC the following analysis as its official comments on the revised rules.

Bioterrorism↗
PubMed1986

Interpretations of requirements for thiamin, riboflavin, niacin-tryptophan, and vitamin E plus comments on balance studies and vitamin B-6.

Data from the long-term projects sponsored by the Food and Nutrition Board to determine the requirements for thiamin, riboflavin, niacin-tryptophan, and vitamin E are utilized to effect an opinion regarding the recommended dietary allowances for these vitamins. Based upon data obtained during these and subsequent research projects, comments on balance studies, changes in tissue lipids, and the requirements for vitamin B-6 are included. The possibility that antioxidants may have an effect on delaying oncogenesis is discussed.

Animals↗
PubMed1979

Algorithm-derived, computer-generated interpretive comments in the reporting of laboratory tests.

The volume of laboratory and other data that physicians encounter daily is more than most can mentally process without oversight or error. Routine use of computer-generated reminders is one solution to this problem that is now widely suggested. We report our experience with the daily use of a user-written program of algorithm-derived, computer-generated comments in the reporting of chemical profiles and routine thyroid function tests in a busy medium-sized privately owned independent clinical laboratory.

Blood Chemical Analysis↗