Biomedical subjects
Publications and source records attributed to B Strauss.
This article extends Clark, Hungerford, and Reilley's (1984) review of dissertations accepted by American universities from 1923 to 1980 by examining dissertations of the 1980s. A table shows which areas of research received the most attention in each of the last 3 decades. There was an increase in the percentage of psychology and educational psychology researchers using hypnosis in dissertations.
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Within a study concerning process and outcome of inpatient longterm group treatments the specific question was tested to what extent characteristics of the "fit" between the therapist and the patients were related to treatment outcome. The study shows that a concordance in the formulation of the treatment goals seems to be favorable for a positive outcome. Similarly, congruences between the therapeutic factors of the group treatment, subjectively important for the patients, and those factors classified as typical for the treatment concept by the therapists, were related to treatment success. The results can be discussed within the context of concepts of the therapeutic alliance and might help to operationalize those concepts in a more specific manner.
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In order to study the conversion of UV lesions into frameshift and base substitution mutations, M13mp2 phage DNA was altered by the addition of extra pyrimidines, or by construction of a nonsense codon preceded by a run of pyrimidines within the beta-galactosidase complementing region. The normal sequence 5' GTC GTT TTA CAA 3' was changed to GTC GTT T TTA CAA (MIDT) or GTC GTT C TTA CAA (MIDC) to study frameshifts and to GTC GTT CTT TAA (OCHRE) to study reversion of the ochre (TAA) codon. Escherichia coli pol I Kf and T7 DNA polymerase mutant enzymes devoid of 3'-->5' exonuclease activity produced UV-induced revertants at higher frequency than did their exonuclease proficient counterparts. Removal of cyclobutane dimers with photolyase before in vitro synthesis did not greatly affect mutant frequency although such treatment led to significantly increased DNA synthesis by the wild-type T7 DNA polymerase on UV-irradiated substrate. Reversions of the in frame ochre sequence GTT CTT TAA produced by the delta 28 T7 DNA polymerase were mainly by base substitution in the TAA codon. About half of the E. coli Kf exo- enzyme ochre revertants had a TTA deletion. Five mutant T7 DNA polymerases with varying exonuclease activity gave revertant frequencies that correlated better with published values of enzyme velocity than with exonuclease activity or with measured bypass synthesis. Our data indicate that loss of proofreading activity increases the frequency of UV-induced frameshifts, but lack of such activity is not sufficient for their production. We suggest that frameshifts occur more frequently when nucleotide addition opposite the lesion is slow. The same lesion can give rise to a different spectrum of mutations depending on the polymerase.
OBJECTIVE: To study whether reviewers aware of author identity are biased in favor of authors with more previous publications. DESIGN: Randomized controlled trial. SETTING: Editorial office of the Journal of Developmental and Behavioral Pediatrics. PARTICIPANTS: Two "blinded" and two "nonblinded" reviewers assigned to 57 consecutive manuscripts submitted between September 1991 and March 1992. OUTCOME MEASURES: Spearman rank correlation coefficients were used to compare the sum of rating scores of 1 to 5 (1, accept; 5, reject) given by the two blinded reviewers, the two nonblinded reviewers, and the editors to the number of articles published previously by the first and senior authors (as determined from requested curricula vitae). Blinded reviewers were sent a questionnaire asking whether they could determine the identity of the authors, how they knew, and whether they thought binding changed the quality or difficulty of their review. RESULTS: The Wilcoxon Sign Rank Test disclosed no differences between blinded and nonblinded scores. The number of previous articles by the senior author was significantly correlated (P < .01) with blinded scores (r = -.45) and editors' decisions (r = -.45), but not with nonblinded scores; the number of articles by the first author was correlated (P < .05) with editors' decisions (r = -.35) but not with blinded or nonblinded scores. Fifty (46%) of 108 blinded reviewers correctly guessed the identity of the authors, mostly from self-references and knowledge of the work; 86% believed blinding did not change the quality of their review, and 73% believed it did not change the difficulty of performing a review. CONCLUSIONS: Blinded reviewers and editors in this study, but not nonblinded reviewers, gave better scores to authors with more previous articles. These results suggest that blinded reviewers may provide more unbiased reviews and that nonblinded reviewers may be affected by various types of bias.
Within a comprehensive research project investigating the outcome and process of inpatient longterm group psychotherapy, the initial and final interviews with the individual patients were video-tape-recorded and analysed using the Vanderbilt Psychotherapy Scales. The ratings of the interviews were related to self descriptions of the patients at the beginning of their psychotherapy, to the patients' perception of the group process during therapy and to the outcomes. In addition the characteristics of the initial and the final interviews were compared with each other. The results indicate process characteristics of the individual interviews to be a useful perspective to thoroughly describe the process and outcome of inpatient psychotherapy.
The paper describes an attempt to evaluate a highly specialized inpatient treatment setting differentially. In addition, it was investigated if patients differing with respect to their outcome, can be discriminated on the basis of their assessments of the basic component of the treatment program, i.e, the psychoanalytically oriented group psychotherapy. 31 patients (treated for approximately 6 months) formed the sample of the study showing that a differential assessment of treatment outcome could clarify questions related to specificities of inpatient settings. It is proposed to develop a basic inventory as well as a basic strategy to intensify differential process and outcome research within the field of inpatient psychotherapy.
Twenty-two patients were enrolled in a clinical trial to determine the toxicity and efficacy of the novel immunomodulator Virulizin in patients with measurable, biopsy-proven pancreatic cancer. The dose was 0.11 ml/kg (minimum 7.5 ml) 3 times weekly for the first week, then twice weekly until disease progression. No toxicity was encountered. In the 17 evaluable patients there was no evidence of tumour regression. Six patients (35%) had disease stabilization for more than 3 months, and 2 are still alive with progressive disease, having had disease stabilization for 15 and 17 months. While the results do not suggest any cytotoxic activity at this dose and schedule, the possibility of an antiproliferative effect warrants further study of this agent.
Based on the situation in the Federal Republic of Germany, this article reviews the development, organization and theoretical framework of in-patient and ward psychosomatic psychotherapy. Indications for treating psychosomatic patients in hospital, the effects of treatment and some results on the process of in-patient psychotherapy are summarized. Some of the specific features of in-patient and ward psychotherapy are adopted as components for a theoretical model of in-patient psychotherapy. Our experience with this form of therapy suggests that it can play an important role within the care system, is a fruitful field for training psychotherapists and acts as an excellent model for further research into psychotherapy.
OBJECTIVE: To compare clinicians' ratings of therapeutic effectiveness when different trial end points were presented as percent reductions in relative compared with absolute risk and as numbers of patients treated to avoid one adverse outcome. DESIGN: Survey, with random allocation of two questionnaires. SETTING: Toronto teaching hospitals. RESPONDENTS: Convenience sample of 100 faculty and housestaff in internal medicine and family medicine. INTERVENTION: One questionnaire presented results for three end points of the Helsinki Heart Study as separate drug trials using only absolute differences in events; the other showed the same end points as relative differences. Both questionnaires included a fourth "trial," showing person-years of treatment needed to prevent one myocardial infarction. MAIN OUTCOME MEASURE: The "trials" were each rated on an 11-point scale, from treatment "harmful" to "very effective." RESULTS: Respondents' ratings of effectiveness varied with the end point. Controlling for end point, ratings of effectiveness by the 50 participants receiving absolute event data were lower than those by 50 participants responding to relative risk reductions (P < 0.001); however, no end-point difference was more than 0.6 scale points. For a "trial" reporting that 77 persons were treated for 5 years to prevent one myocardial infarction, mean ratings were 2.3 or 1.8 scale points lower, respectively (both P < 0.001), than when the same data were shown as relative or absolute risk reductions. CONCLUSIONS: Clinicians' views of drug therapies are affected by the common use of relative risk reductions in both trial reports and advertisements, by end-point emphasis, and, above all, by underuse of summary measures that relate treatment burden to therapeutic yields in a clinically relevant manner.
The sample for this psychosocial follow-up study was formed using the 71 surviving patients from a total of 100 who underwent heart transplantation up until March 1990 at Kiel University Hospital. Forty of these could be investigated comprehensively. The neurological investigation comprised EEG and auditory and visually evoked potentials. The psychological investigation started with several neuropsychological tests; additionally all patients were interviewed and they completed questionnaires concerning anxiety, depression, ways of coping, personality characteristics and life satisfaction. Within the entire sample, there were few indications for specific psychological impairment. The psychosocial status of the patients was not significantly related to the time which had elapsed since they underwent transplantation. There were few associations between neuropsychological and psychosocial data, and several indicators of early postoperative complications which are described in the literature (e.g., length of stay in the intensive care unit). Clinically relevant subgroups (formed on the basis of neuropsychological test results, anxiety and depression) did not differ in terms of these indicators. Nevertheless, a considerable proportion of the patients (25%) were characterized by having a higher level of affective and neuropsychological impairment. Although based upon retrospective investigations, the results of this follow-up generally correlate with those gained from Anglo-American countries. In interpreting the results one needs to consider the possible influence of premorbid personality characteristics as well as denial which may be typical for patients undergoing heart transplantation.
In a prospective study of psychological and neurological reactions to coronary artery bypass surgery, 45 patients were examined preoperatively, postoperatively, and 21 to 27 months after, using a variety of neurological, psychiatric, and psychological investigations. Within the follow-up sample, three subgroups of patients could be identified by cluster analysis who differed with respect to their emotional status and life satisfaction. One group (24% of the total sample) was characterized by high levels of anxiety, depression and life dissatisfaction and appears as a risk population. The other groups could be described as either average (42%) or stable (33%). At the follow up, the risk group further indicated a preference for depressive coping styles, a slightly higher degree of cognitive impairment, more neurological and psychopathological symptoms (specifically giving-up and hostility), a considerably lower return-to-work rate, more subjective physical complaints and a poorer attitude toward the outcome. While postoperative measurements (obtained 2-3 and 6-8 days after surgery) as well as intraoperative parameters did not reveal significant group differences, the analysis yielded an increased impairment within the risk group already prior to surgery, especially emotional problems, specific health-related cognitions and a more fatalistic attitude. The results are in line with those of other studies investigating the late postoperative psychological status with regard to the proportion of patients showing psychological impairments as well as to their specific psychological characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)
Based upon existing psychological studies of endometriosis, the hypothesis was tested if patients suffering from this disorder differ from other infertile females with respect to psychological characteristics. Using questionnaires as well as a semi-structured psychotherapeutic interview 38 patients with endometriosis and 18 females with tubal sterility were investigated. A comparison of both groups indicated a higher level of anxiety and some evidence for a somatic preoccupation in the endometriotic patients. The analysis of the interviews (which were judged by several independent raters) confirmed the hypothesis of gender role conflicts in combination with endometriosis. This conflict seemed to be characterized by a negative experience of menarche and puberty, early gynecological problems and negative sexual experiences. This constellation is illustrated using a typical case. Based upon these results, further studies of endometriosis using a psychosomatic perspective seem to be promising.
The Vanderbilt-Psychotherapy-Scales appeared to be useful instruments for the identification of process characteristics determining the outcome of brief dynamic psychotherapies. The German versions of the two scales measuring important components of the psychotherapeutic process and of negative indicators are described in this article. It could be shown that--similar to the original versions--both scales can be used economically and that rater agreement soon reaches satisfactory levels. To demonstrate the potential use of the scales, their application in two different short term treatments are described which are presently analysed in a multi-center study of "single case oriented process research" using a variety of different methods. The example demonstrates that both scales are useful to discriminate both different theoretical foundations of the treatments as well as specific features of the patients and their therapists. The usefulness of the scales in a broader context is mainly based upon the experience that they reveal a lot of important informations about the psychotherapeutic process with a minimum of expense.
Nutritional diagnosis and management are important aspects of general practice. This information, which is presented in two parts, offers the general practitioner a practical framework and an approach to nutritional advice. Part 1 outlines the clinical conditions and principles involved in nutritional diagnosis with a management approach to macrovascular disease and obesity. Part 2 covers protein malnutrition, eating disorders, osteoporosis, nutrient toxicity, cancer, inherited metabolic disorders, nutrient deficiency and diabetes mellitus. This material is based on a seminar organised by Kellogg (Australia) Pty Ltd in Melbourne in 1989 and the material is reproduced with the kind permission of Kellogg (Australia) Pty Ltd.
Nutritional diagnosis and management are important aspects of general practice. This information, presented in two parts, offers the general practitioner a practical framework and a approach to nutritional advice. Part 2 covers protein malnutrition, eating disorders, osteoporosis, nutrient toxicity, cancer, inherited metabolic disorders, nutrient deficiency and diabetes mellitus. (Part I, outlining the clinical conditions and principles involved in nutritional diagnosis with a management approach to macrovascular disease and obesity, appeared in the October issue of Australian Family Physician.)