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Biomedical subjects

D Beck

Publications and source records attributed to D Beck.

176 records · Page 10Linked to original sources
PubMedDate not supplied

Two models of in-service training to improve midwifery skills: how well do they work?

This program evaluation compared the knowledge, confidence, and skills of Indonesian village midwives who attended an intensive in-service training with midwives who received an internship program and midwives who attended no program. The five key skills compared were prevention of infection, use of the partograph, manual removal of placenta, bimanual uterine compression, and neonatal resuscitation. Midwives from the intensive in-service that combined competency-based skill training with peer review and continuing education scored higher on the knowledge test and demonstration of the five key skills and reported managing complications better than midwives who attended no training program. Midwives from the internship program scored intermediate between the intensively trained and the untrained midwives. Overall, skill scores were 71% for midwives in the intensive program, 62% for the interns, and 51% for midwives with no in-service training. Village midwives from the intensive program scored significantly higher in the practical demonstration of manual removal of placenta, bimanual compression, and neonatal resuscitation than the interns, but the scores on infection prevention and use of the partograph were not different between the two groups. Differences in the volume of training opportunities between the two programs could be responsible for the different outcomes.

Clinical Competence↗
PubMedDate not supplied

Home based life saving skills: promoting safe motherhood through innovative community-based interventions.

In much of the developing world, home birth with unskilled attendants is the norm, and maternal and neonatal mortality rates are high. A comprehensive approach to address this problem needs to upgrade referral facilities and strengthen the skills of trained health care providers. To improve pregnancy outcomes, a program must also provide education, motivation, and mobilization of pregnant women, families, and communities (whose members must come to a common understanding of the need for and the means to prevent death of a woman or neonate). Consequently, the American College of Nurse Midwives (ACNM) has expanded the Life Savings Skills Series to include Home Based Life Saving Skills (HBLSS). HBLSS is a community and competency-based program that aims to reduce maternal and neonatal mortality by increasing access to basic life saving measures within the home and community and by decreasing delays in reaching referral facilities where life-threatening problems can be managed.

Community Health Services↗
PubMedDate not supplied

Consolidation radiation therapy following cytoreductive surgery, chemotherapy and second-look laparotomy for epithelial ovarian carcinoma: long-term follow-up.

BACKGROUND: From 1979-1987, 139 stage IC-IV ovarian cancer patients who had undergone cytoreductive surgery received 6-11 cycles of cisplatin and adriamycin. STUDY DESIGN: Eighty-four clinically complete responders underwent second-look laparotomy, and 60 of them received consolidation abdominal irradiation. The patients were then followed for a median follow-up of 39 months. RESULTS: Five- and 10-year actuarial survival for all patients was 43% and 24%, for no residuum at primary surgery, 80% and 35%, for residual tumor <2 cm, 45% and 35%, and for residual tumor >2 cm, 20% and 4%. Median survival for stage III-IV patients negative at second-look laparotomy was 72 months in irradiated compared to 25 months in non-irradiated patients (P = 0.14) and 77 months in irradiated patients with microscopic disease at second-look laparotomy. Median survival in patients with macroscopic disease at second-look laparotomy was 23.5 months if irradiated compared to 18 months if not (P = 0.05). CONCLUSIONS: Consolidation whole abdominal irradiation in advanced stages of ovarian cancer may be of value in patients with negative or microscopic disease at second-look laparotomy. Unfortunately, despite the initial survival advantage observed in irradiated patients, owing to late recurrences there was no significant difference in their long-term survival probability.

Adult↗
PubMedDate not supplied

Prolonged remission induced by cyclosporine in a patient with familial thrombocytopenia and enteropathy.

A 21-year-old patient, since the age of 16, presented a familial type of chronic autoimmune thrombocytopenia that responded only partially to various types of immunosuppressive treatment. His prolonged survival, compared to his decreased siblings, was complicated by the appearance of a severe enteropathy. High doses of corticosteroids induced a type 1 diabetes as a major side effect. The introduction of cyclosporine resulted in both a continuous complete clinical remission and a partial hematological remission and allowed the discontinuation of all other medication for 18 months. In uncommon complex autoimmune disease, cyclosporine may represent a safe and effective alternate therapy when other immunosuppressive agents have failed.

Adult↗
PubMedDate not supplied

[Psychosomatic aspects of breast carcinoma].

Psychological differences were compared between 25 female patients with carcinoma of the breast (mamma) and 25 patients with mastopathia cystica fibrosa. Our methods consisted in psychoanalytical interviews and MMPI-tests. We investigated the early childhood-period, the object relationships, the structurs of the personality and the psychological stress before the beginning of the physical illness. Patients with carcinoma of the breast show more frequent broken home situations, and inclination to idealize the past, depressive traits and a tendency to repress inner conflicts. The sexual behavior shows statistically more frequent abortions in the cancer group. In the beginning of the cancer we found statistically more frequent the loss of a meaningful personal relationships (e.g. death of the mother). Several differences between the personal structure were also found in the MMPI-tests.

Adult↗
PubMedDate not supplied

Monoclonal antibodies to gamma-interferon treated LAN-1 cells detect modulation of ganglioside GD2 exposure on human neuroblastoma cells.

A panel of 8 new Mabs have been produced against neuroblastoma cells (LAN-1) previously treated with IFN-gamma. All selected Mabs from 2 different fusions have been shown to detect epitopes on the GD2 ganglioside molecules highly expressed on all cells of neural crest origin including neuroblastoma, glioblastoma and melanoma. Our results imply that modulation of GD2 exposure on NB cells is dependent on culture conditions and moreover that IFN-gamma increases the surface expression of GD2 and thereby enhances their immunogenicity.

Antibodies, Monoclonal↗
PubMedDate not supplied

[Psychoanalytic aspects of migraine].

After a clinical example the migraine attack is interpreted as an attempt to reparate the hurted self. A comparison with psychoanalytic literature shows that migraine attacks were seen in the past above all under dynamic aspects of the drives and not under a narcisstic point of view. Specific genetic influences lead to a negative cathexis of the self and to obsessional defenses against sadness and mourning. The migraine attack generally decrease in the middle age of the life because of cathexis-changes in the self and a reduction of the libidinal drive in this age.

Adult↗
PubMedDate not supplied

[Psychodynamics of psychogenic fever].

In this study we aimed to formulate a psychological framework on the origins of vegetative fever. Our sample comprised 13 patients. Concerning the structure of personality we found, that all the patients came from broken homes, that they showed pronounced disturbances in their inter-personal relationships, that they had developed an extremely exigeant ideal ego and that they strongly suppressed their aggressiveness. We were able to define two characteristic situations which can trigger vegetative fever; the break-down of the ideal ego due to external traumatic circumstances and the threat of the disolution of a symbiotic relationship. Beside the vegetative fever all our patients showed a great number of other psychological or functional disturbances. Only a few of the psychologically severely affected patients could be treated with psychotherapy. The pronounced tendency to somatize with a strong libidinal cathexis of the whole organism can be interpreted as an attempt to restore the feeling of coherence of the ego in order to avoid it's psychotic break-down (Meng).

Adolescent↗