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PubMed2000

Detection of emerging resistance patterns within longitudinal surveillance systems: data sensitivity and microbial susceptibility.

Communicating information from antimicrobial resistance surveillance study data to microbiologists and physicians can be challenging. Large amounts of data, commonly reaching millions of MICs or zone 20diameter endpoints, must be analysed and condensed to easily-read tables or figures. Furthermore, data must not be prejudged relative to susceptibility categories, because of the diverse nature of interpretive criteria available internationally. An attempt must be made to present results of all surveillance studies in a mode that can be reinterpreted for immediate use in different geographical areas, or used to compare future data with relative ease and high accuracy. Such data displays require peer-reviewed journals to permit greater numbers of more complex tables to present results. The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) study is a year-on-year global surveillance programme in medical centres where meropenem is available for use. We have developed a presentation strategy that expands the long-term clinical value of MYSTIC results. In addition to statistical parameters, tables of cumulative percentages or numbers of strains inhibited at each tested antimicrobial concentration will be presented. Alternative figures (Finland-o-grams) could also be used, but these generally lack precise extractable rates and require more journal space. Regardless of study design, promotion of this presentation philosophy enhances any surveillance study's value to each reader or user and facilitates application to locally appropriate interpretations. The widespread use of these analysis and presentation principles as benchmarks by various resistance studies and networks is strongly encouraged, particularly by investigations across international boundaries.

Journal Article↗
PubMed1979

Race and sex as variables affecting reactions to disability.

Several aspects of reaction to disability were compared across samples of rehabilitation patients which differed in race and sex. Subjects included 28 black men, 14 white men, 19 black women, and 19 white women who had a range of different disabilities and who were patients at a large public hospital and a small rehabilitation center in a southeastern metropolis. Losses attributed to disability were found to vary for men and women, except that inability to work was missed most by all subjects. Only black men emphasized themselves, their jobs, and other persons as reasons for their disability. All subjects were most likely to cite mystical causes for their disability and to believe that mystical sources would most help them to improve.

Black or African American↗
PubMed2005

Knowledge and practices of traditional birth attendants in prenatal services in Lagos State, Nigeria.

A questionnaire-based study was conducted on 189 Traditional Birth Attendants (TBAs) on their knowledge and practices in prenatal services. Only 86 (45.5%) of them associated cessation of menstrual period with pregnancy while others use mystic power 46 (24.3%), early morning sickness, pallor of conjunctiva and reaction to herbs 56 (29.6%) to detect pregnancy. Fundal height n=76 (40.2%), palpation n=82 (43.4%), special soaps and soups n=52 (27.5%) and special devices n=8 (4.2%) are used to determine stages of pregnancy. Foetal health status is determined by regular foetal movements n=95 (50.3%), mystic power n=15 (8%), soap n=2 (1.1%), special concoction 9 (4.8%), health status of mother n=67 (35.4%) and foetal heart beat n=24 (12.7%). Ninety seven (51.3%) of them used herbal treatment, 77 (40.7%) used incantations, 189 (100%) used special soaps as their main methods of delivery, while only 18 (9.5%) of respondents refer difficult cases to hospitals. Instruments used for separating cord were blade 123 (65.1%) and scissors 40 (21.1%). Symptoms recognized by the TBAs as signs of complications in pregnancy were dizziness, swollen feet, pallor, tiredness, absent foetal movement, loss of appetite, heaviness, pain in back/stomach/side, weight loss, vomiting, bleeding, fever/malaria, head ache, bad dream, premature or delayed labour. Although some of them recognized some danger signs in pregnancy and labour, only very few would refer difficult cases for emergency obstetric interventions. Clear protocols for management and referral, which are necessary for improved maternal survival, should be provided through regular training of the TBAs.

Clinical Competence↗
PubMed1981

From psychotherapy to psychoanalysis: Frederik van Eeden and Albert Willem van Renterghem.

At the end of the nineteenth century, the unconscious was discovered by various students of the human mind. No agreement existed, however, about its nature--whether it represented the seat of the abnormal, the supranormal, or both. Frederik van Eeden (1860-1932), better known as a writer than as a physician, and Albert Willem van Renterghem (1846-1939), a country doctor, were both attracted by the philosophy of psychic monism and were disappointed by official medical science. They felt that the mind played a greater role in curing and healing than official medicine could acknowledge. Van Eeden, a socialist, moved away from medical science. Fascinated by psychical research, he embraced Spiritualism and joined the Roman Catholic Church. His attitude toward psychoanalysis was ambivalent. Van Renterghem, by contrast, became a respected and well-to-do psychiatrist, and was one of the first Dutch physicians to embrace psychoanalysis. This study of two Dutch psychiatrists shows on the one hand that only gradually the mystically tinged soul of the first dynamic psychiatry became the conscious and unconscious mind of depth psychology, and on the other hand that the reception of psychoanalysis was furthered by the prevailing interest in mysticism.

History, 19th Century↗
PubMed1975

Observations on a sidewalk ashram.

Meetings between an American guru and his followers were observed and 14 of the devotees were interviewed. Virtually all gave histories of chronic unhappiness and unsatisfactory parental relations. On involvement with the guru and a new 'family,' the experienced increased well-being and periods of bliss, and their acceptance of mystic Hindu beliefs was solidified. Factors relating to the devotees' psychological 'lift' are delineated, including ways that the bond to the leader possibly aided them in dealing with inner conflict. Earlier experiences with psychedelic drugs appeared to have influenced many of the subjects to Hinduism and the guru. It is postulated that a psychological characteristic of the devotees is a strong underlying wish for union with a powerful object,and that this bore on their susceptibility to the influence of certain regressive psychedelic experiences.

Adult↗
PubMed1986

Herbalism and divination in southern Malawi.

Although contemporary anthropological studies of African medical systems have indicated their pluralistic and complex nature, many studies still suggest a stark contrast between folk and cosmopolitan medicine, implying that ethnomedicine is primarily concerned with mystical causation. The present paper outlines ethnomedical practices in southern Malawi, stressing the distinctiveness of herbalists and diviners, and the important role of herbal remedies in the empirical treatment of all illnesses.

Adult↗
PubMed2002

Cross-cultural encounters between careproviders: rabbis' referral letters to a psychiatric clinic in Israel.

This paper explores the meaning and social functions of referral letters sent to a mental health clinic in Israel by Haredi (ultra-orthodox) rabbis. The letters exemplify social mechanisms by which various institutions and individuals (careproviders, therapists, and other social actors) negotiate different therapies, advice, and interventions in cross-cultural encounters. We argue that beyond the practical functions of the letters, the rabbis-representatives of a "popular" and religious social sphere-use them to negotiate their position in relation to the psychiatric clinic as a representative of a professional and secular sphere. We show that the rabbis "submit" to the professional and secular therapists by using a local adaptation of Western psychological and psychiatric discourses (instead of a religious or mystical discourse), but also that by choosing a letter as their preferred medium of communication (instead of a personal visit to the clinic), they distance themselves from it. We suggest that the rabbis reconstitute, via the letters, social boundaries within their religious community and between their community and secular society. Hence, through analysis of discourses of mental illness in a cross-cultural encounter we examine ways in which illness is practically managed among diverse groups in society. Specifically, we analyze such discourses as part of a power relationship between careproviders who belong to different therapeutic social spheres, using a phenomenological exploration of how mental illness is perceived and constructed as both "a medical problem" and as "social deviance".

Clergy↗
PubMed1999

Jung and the Kabbalah.

Jung's use of Kabbalistic symbols and ideas as well as his personal Kabbalistic vision are critically examined. It is argued that as great as Jung's acknowledged affinity is to the Kabbalah, his unacknowledged relationship was even greater. Jung has been accused of being a contemporary Gnostic; however, the interpretations Jung placed on Gnosticism and the texts Jung referred to on alchemy were profoundly Kabbalistic, so much so that one would be more justified in calling the Jung of the Mysterium Coniunctionis and other late works a Kabbalist in contemporary guise. Although Jung, at least during the 1930s, appears to have had powerful motives that limited his receptivity to Jewish ideas, his highly ambivalent and at times reproachable attitude toward Judaism should not prevent one from appreciating the affinities between Jungian psychology and Jewish mystical thought.

History, 20th Century↗
PubMed2003

Antimicrobial activity against strains of Escherichia coli and Klebsiella spp. with resistance phenotypes consistent with an extended-spectrum beta-lactamase in Europe.

Extended-spectrum beta-lactamases (ESBLs) have continued to evolve after their initial detection in Europe nearly two decades ago. The summary results from the MYSTIC Program (31 medical centers) were utilized to assess the extent of ESBL occurrence in Europe from 1997 to 2000. ESBL phenotype rates in Klebsiella spp. (32.8%) and Escherichia coli (14.4%) were generally stable, but extensive hospital-to-hospital and unit-to-unit variations were noted. The highest ESBL rates were found in eastern Europe (including Turkey) and in intensive care unit patient populations. Carbapenems remained active against the ESBL-producing strains (meropenem MIC90, 0.25-1 mg/L), while some other agents, such as aminoglycosides, fluoroquinolones, and piperacillin-tazobactam, were significantly less effective. International surveillance initiatives should be maintained to monitor future progression of this important resistance.

Anti-Bacterial Agents↗
PubMed2003

The activity of meropenem and comparators against Acinetobacter strains isolated from European hospitals, 1997-2000.

In vitro susceptibilities to meropenem and comparators of Acinetobacter strains isolated from serious infections in 37 European hospital centers participating in the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program (1997-2000) were tested. There were 635 Acinetobacter strains collected: 490 A. baumannii; 51 A. calcoaceticus var. lwoffii; and 94 other Acinetobacter strains. Overall, meropenem and imipenem were the most effective agents tested. Resistance to the antimicrobials was: 14%, meropenem; 16%, imipenem; 39%, piperacillin-tazobactam; 41%, tobramycin; 45%, ceftazidime; and 53%, ciprofloxacin. Thus, the carbapenems have useful activity against Acinetobacter spp. and represent a viable choice for treating infections caused by these organisms.

Acinetobacter↗
PubMed1998

[Occultism, parapsychology and the esoteric from the perspective of psychopathology].

The concepts and main themes of occultism, parapsychology and esoterics are set in comparison to religion, spirituality, mysticism. The cultural relativity of these concepts is emphasised. Occultism means dealing with phenomena, processes, and/or powers which are not accessible to "normal perception". The manipulation of such powers is effected via (white, black, grey) magic. Parapsychology, in its popular sense, deals with occult phenomena, whereas scientific parapsychology investigates them empirically. Esoterics is a complex of beliefs within a hermetic tradition about occult processes and about desting after death. Transpersonal psychology deals with these issues while calling them "spiritual". Effects of paranormal experiences and actions on the side of the actor as well as the adept are discussed: personality types, interpersonal effects, crises and psychoses (mediumistic psychoses). The concept of dissociation of subpersonalities (subselves) appears to be a viable perspective to explain these phenomena. In mediumistic psychoses, the splitting of non-ego parts of the psyche leads to a manifestation of schizophrenic symptoms. Dangers for mental health are an ego inflation by self-attribution of "superhuman" power. A personality disposition for parapsychological perception and/or action may be seen in schizotypia and similar near-psychotic "personalities up the border". Adepts of occultism may present with a "false self" in the sense of Winnicott.

Humans↗
PubMed1990

Order and healing: the concept of order and its importance in the conceptualization of healing.

This paper concerns the notion of order and its role in the conceptualization of healing, and therefore its importance to healing itself. It proposes a model of healing in which order is central. The paper begins with an example drawn from Javanese mystical practices which are based upon the concept of the unity of the human and natural orders. The Javanese case provides a metaphor for an expanded notion of order. This prefigures a consideration of the nature of the concept of order in medical anthropology, science, and medicine. The importance of the notion of analogy (and metaphor) in the concept of order and how order may be simultaneously conceptualized in both cognitive and biological domains is also discussed in the paper. The perspective on order and healing developed here goes beyond conventional biomedical categories and provides a basis for the fundamental reconceptualizations necessary for addressing contemporary developments in psychoneuroimmunology, for example.

Attitude to Health↗
PubMed2001

Alternative medicine and common errors of reasoning.

Why do so many otherwise intelligent patients and therapists pay considerable sums for products and therapies of alternative medicine, even though most of these either are known to be useless or dangerous or have not been subjected to rigorous scientific testing? The author proposes a number of reasons this occurs: (1) Social and cultural reasons (e.g., many citizens' inability to make an informed choice about a health care product; anti-scientific attitudes meshed with New Age mysticism; vigorous marketing and extravagant claims; dislike of the delivery of scientific biomedicine; belief in the superiority of "natural" products); (2) psychological reasons (e.g., the will to believe; logical errors of judgment; wishful thinking, and "demand characteristics"); (3) the illusion that an ineffective therapy works, when actually other factors were at work (e.g., the natural course or cyclic nature of the disease; the placebo effect; spontaneous remission; misdiagnosis). The author concludes by acknowledging that when people become sick, any promise of a cure is beguiling. But he cautions potential clients of alternative treatments to be suspicious if those treatments are not supported by reliable scientific research (criteria are listed), if the "evidence" for a treatment's worth consists of anecdotes, testimonials, or self-published literature, and if the practitioner has a pseudoscientific or conspiracy-laden approach, or promotes cures that sound "too good to be true."

Cognitive Dissonance↗
PubMed1998

Abandoning biomedicine for alternate therapies: oncology patients' stories.

Little is known of the experiences of oncology patients who abandon biomedicine to use alternate therapies. This ethnography provides insights into the experiences of eight estranged informants. Six main themes emerging from the analysis are (a) expressed stress: emotions such as anger and fear, (b) taking control, (c) belief in a cure, (d) social group association, (e) cost considerations, and (f) mystical insights into health care. Conducted over 3 years, the study includes a network sample and longitudinal case study with one key witness. Individual interviews and one focus group were included. Insights are provided for health professionals who may encounter biomedical abandonment.

Adult↗
PubMed1992

Toward a more culturally sensitive DSM-IV. Psychoreligious and psychospiritual problems.

In theory, research, and practice, mental health professionals have tended to ignore or pathologize the religious and spiritual dimensions of life. This represents a type of cultural insensitivity toward individuals who have religious and spiritual experiences in both Western and non-Western cultures. After documenting the "religiosity gap" between clinicians and patients, the authors review the role of theory, inadequate training, and biological primacy in fostering psychiatry's insensitivity. A new Z Code (formerly V Code) diagnostic category is proposed for DSM-IV: psychoreligious or psychospiritual problem. Examples of psychoreligious problems include loss or questioning of a firmly held faith, and conversion to a new faith. Examples of psychospiritual problems include near-death experiences and mystical experiences. Both types of problems are defined, and differential diagnostic issues are discussed. This new diagnostic category would: a) improve diagnostic assessments when religious and spiritual issues are involved; b) reduce iatrogenic harm from misdiagnosis of psychoreligious and psychospiritual problems; c) improve treatment of such problems by stimulating clinical research; and d) encourage clinical training centers to address the religious and spiritual dimensions of human existence.

Culture↗
PubMed2000

Assessing problems with religious content: a comparison of rabbis and psychologists.

This study measured distinctions made by a sample of clergy and mental health professionals in response to three categories of presenting problems with religious content: mental disorder, religious or spiritual problem, and "pure" religious problem. A national, random sample of rabbis (N = 111) and clinical psychologists (N = 90) provided evaluations of three vignettes: schizophrenia, mystical experience, and mourning. The participants evaluated the religious etiology, helpfulness of psychiatric medication, and seriousness of the presenting problems. The rabbis and psychologists distinguished between the three diverse categories of presenting problems and concurred in their distinctions. The results provide empirical evidence for the construct validity of the new DSM-IV category religious or spiritual problem (V62.89). Use of the V code allows for more subtle distinctions among the variety of problems that persons bring to clergy and mental health professionals. These distinctions may also provide a foundation for the initiation of co-professional consultation.

Attitude of Health Personnel↗
PubMed2006

Spiritual but not religious? Evidence for two independent dispositions.

Some psychologists treat religious/spiritual beliefs as a unitary aspect of individual differences. But a distinction between mysticism and orthodox religion has been recognized by scholars as well as laypersons, and empirical studies of "ism" variables and of "spirituality" measures have yielded factors reflecting this distinction. Using a large sample of American adults, analyses demonstrate that subjective spirituality and tradition-oriented religiousness are empirically highly independent and have distinctly different correlates in the personality domain, suggesting that individuals with different dispositions tend toward different styles of religious/spiritual beliefs. These dimensions have low correlations with the lexical Big Five but high correlations with scales (e.g., Absorption, Traditionalism) on some omnibus personality inventories, indicating their relevance for studies of personality.

Female↗
PubMed1999

Prevalence of epilepsy in Silivri, a rural area of Turkey.

PURPOSE: To learn the prevalence of epilepsy in Silivri, a western town of Turkey, a randomized door-to-door survey was conducted using a standard questionnaire. The method of the study was adopted from the suggestions of the World Health Organization (WHO) for prevalence studies in developing countries, and the criteria were derived from Guidelines for Epidemiologic Studies on Epilepsy proposed by the Commission on Epidemiology and Prognosis, the International League Against Epilepsy (ILAE) 1993. METHODS: From June 1 to October 1, 1994, 4,803 people out of a total population of 70,394 were surveyed. The questionnaire, which was administered by practitioners and intern doctors, consisted of 15 questions, with a sensitivity of 99.9% and a specificity of 76%. After the survey, neurologists examined all of the 415 people suspected of having epilepsy and classified the seizures of the active cases. RESULTS: Of the 415 suspected cases, 49 people (24 women, 25 men) were determined as having epilepsy on the assessment day of October 1, 1994. The crude point prevalence of active epilepsy was 10.2 of 1,000 for the region. The prevalence of active epilepsy among women was 10.01 of 1,000 and among men was 10.39 of 1,000. Of the 49 cases, 40.8% had generalized seizures, 53.1% had partial onset seizures, and 6.1% could not be classified. Only 7.7% of the cases with partial onset seizures were defined as probable symptomatic cases. CONCLUSIONS: Onset of the disease peaked at the first decade of life. On the assessment day, 44.9% of those with epilepsy were receiving treatment, and 65.1% had visited religious figures at the onset or during the course of the disease, a figure that reveals the high prevalence of mystical beliefs about the disease in the study area.

Adolescent↗