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PubMed1983

Information processing and lateralization in schizophrenia.

This experiment investigated two current approaches in the study of schizophrenic thought, information processing and hemispheric specialization. Ten paranoid and ten nonparanoid schizophrenics, ten nonschizophrenic psychiatric controls, and ten normal controls were presented three tasks tachistoscopically. The tasks, letter-naming and dot enumeration of unstructured and structured arrays, were designed to elicit left and right hemisphere functioning through automatic and controlled information-processing strategies. Hemisphere effects were significant in the letter task with the left hemisphere superior to the right for all groups. Position effects were also significant, suggesting that reading habits determine this function and the ability was shared by all psychiatric groups. The normal control group identified a significantly greater number of letters than all other groups which may suggest that the lower performance of the psychiatric groups was due to a general level of psychiatric pathology. The two dot enumeration tasks indicated that, unlike the other three groups, the nonparanoid group processed the dots using an automatic strategy but only in the left hemisphere. Right hemisphere processing was essentially the same for all groups. The left hemisphere performance of the nonparanoid replicates that of a previous study and leads us to consider the left hemisphere dysfunction as specifically related to nonparanoid schizophrenics and the dysfunction as the inability to process information in a serial manner.

Adult↗
PubMed1985

Transpersonal processes and the Oedipal phase of development.

This paper is an extension of previous theoretical work in which a bimodal theory of the psychology of relationships and personality function was elaborated. The two modes are, essentially, the traditional intrapsychic individual mode derived from dyadic and introspective methods of observation, and a transpersonal mode, derived in the main from family and group process observations. The role of projective identification and other so-called primitive mechanisms are explored and their defensive and adaptive role in transpersonal transactions in small and large groups examined. The implications for the theory of the mother-infant relationship, and in particular the separation-individuation phase, is reviewed and the further development of the transpersonal concept summarized. These ideas are developed in an examination of the influence of these processes on Oedipal phase conflicts in an eight-year-old boy, with illustrative case material. The conclusion is drawn that manifest Oedipal phase anxieties and conflicts are frequently, if not always, an expression of transpersonal elaboration in the family group. In these circumstances, the transpersonal processes are defensive rather than adaptive and impair the child's normative individuation and the usual repression and resolution of the Oedipal complex. Freud's study of Little Hans is re-examined from this viewpoint. The implications for therapy are noted.

Adult↗
PubMed1983

Aphasics' perception of words in sentential context: some real-time processing evidence.

The perception of words belonging to different grammatical classes was investigated in Wernicke's and Broca's aphasics. The experimental used a word monitoring task, which varied the target's word class, as well as the sentential context. The sensitivity to semantic context was very similar for both aphasic groups. Processing differences for the two groups were found, however, with respect to different word classes. It appears that Broca's aphasics are unable to process grammatical morphemes as features of a phrasal frame. Wernicke's aphasics, however, seem to retain the ability to process syntactic as well as some semantic information, at least, during sentence perception.

Adult↗
PubMed2005

Effect of lateral positioning on upper airway size and morphology in sedated children.

BACKGROUND: Lateral positioning decreases upper airway obstruction in paralyzed, anesthetized adults and in individuals with sleep apnea during sleep. The authors hypothesized that lateral positioning increases upper airway cross-sectional area and total upper airway volume when compared with the supine position in sedated, spontaneously breathing children. METHODS: Children aged 2-12 yr requiring magnetic resonance imaging examination of the head or neck region using deep sedation with propofol were studied. Exclusion criteria included any type of anatomical or neurologic entity that could influence upper airway shape or size. T1 axial scans of the upper airway were obtained in the supine and lateral positions, with the head and neck axes maintained neutral. Using software based on fuzzy connectedness segmentation (3D-VIEWNIX; Medical Imaging Processing Group, University of Pennsylvania, Philadelphia, PA), the magnetic resonance images were processed and segmented to render a three-dimensional reconstruction of the upper airway. Total airway volumes and cross-sectional areas were computed between the nasal vomer and the vocal cords. Two-way paired t tests were used to compare airway sizes between supine and lateral positions. RESULTS: Sixteen of 17 children analyzed had increases in upper airway total volume. The total airway volume (mean +/- SD) was 6.0 +/- 2.9 ml in the supine position and 8.7 +/- 2.5 ml in the lateral position (P < 0.001). All noncartilaginous areas of the upper airway increased in area in the lateral compared with the supine position. The region between the tip of the epiglottis and vocal cords demonstrated the greatest relative percent change. CONCLUSIONS: The upper airway of a sedated, spontaneously breathing child widens in the lateral position. The region between the tip of the epiglottis and the vocal cords demonstrates the greatest relative percent increase in size.

Anesthesia↗
PubMedDate not supplied

Clinical decisions: defining meaning through focus groups.

In this article, the author illustrates the use of an adapted focus group process. He uses the example of canvassing the views of registered mental health nurses about the meaning of the term clinical decision. The article centres on the process involved in what the author has called 'the grounded focus group', a combination of traditional focus group work with analysis techniques drawn from grounded theory. The author describes the techniques involved, and offers a practical guide to the application of such groups, discussing the skills and important concerns involved in facilitating focus groups of this type.

Data Collection↗
PubMed1996

Utilizing quality assurance as a tool for reducing the risk of nosocomial ventilator-associated pneumonia.

A multidisciplinary group was formed to develop strategies to reduce ventilator-associated lower respiratory tract infections (LRI) in an intensive care unit (ICU) of a 540-bed acute care teaching medical center. The group process was facilitated by the Infection Director and the quality management specialist. The group was made of medical, nursing, and respiratory therapy staff. Quality improvement techniques were used to define the process of care for ventilated patients in the ICU. "State of the art" care was defined after a literature review and brainstorming sessions. Current practice and new concepts were then forged into a realistic protocol for the ICU. The resulting protocol was introduced into the ICU in May 1992. The information was communicated to Respiratory Therapy and ICU staff in writing and at department meetings. After a 4-month introductory period and learning curve process, a decrease in the endemic rate of ventilator-associated LRI was reduced in the fourth quarter of 1992. The mean 1993 LRI rate was 21 LRI/1000 ventilator days versus 26 LRI/1000 ventilator days in 1992 before protocol implementation. This equates to 18 LRI prevented in 1993. This represents a savings of $126,000. There was a significant decrease in the process variation of the monthly mean LRI/1000 ventilator days in 1993 from 1992. To date, there continues to be improvement with a mean of 16 LRI/1000 ventilator days reported in 1994. The ICU staff developed a multidisciplinary process evaluation and monitored staff implementation of the protocol over time. The results of the evaluation were used as feedback to measure protocol implementation. This was found to improve compliance with the protocol. Both the process (care of ventilated patients) and the outcome (number of LRI) have been improved through use of continuous quality improvement concepts and transdisciplinary interventions.

Clinical Protocols↗
PubMed2003

Analysis of group differences in processing speed: Brinley plots, Q-Q plots, and other conspiracies.

Researchers in a growing number of areas (including cognitive development, aging, and neuropsychology) use Brinley plots to compare the processing speed of different groups. Ratcliff, Spieler, and McKoon (2000) argued that a Brinley plot is a quantile-quantile (Q-Q) plot and that therefore Brinley plot regression slopes measure standard deviation ratios rather than relative speed of processing. We show that this argument is incorrect. Brinley plots, by definition, are not Q-Q plots; the former are based on unranked data and the latter are based on ranked data. Furthermore, the relationship between standard deviation ratios and slopes is a general property of regression lines and has no implications for the use of Brinley plot regression slopes as processing speed measures. We also show that the relative speed interpretation of Brinley plot slopes is strongly supported by converging evidence from a metaanalysis of visual search, mental rotation, and memory scanning in young and older adults. As to Ratcliff et al.'s hypothesis that age differences in response time are attributable to greater cautiousness on the part of the elderly, rather than true processing speed differences, this hypothesis has been extensively tested in previous studies and found wanting.

Adult↗
PubMed1998

Nourishing the body through use of process prescriptions in group therapy.

OBJECTIVE: This clinical report describes a creative process for developing between-session prescriptions which sustain and strengthen the momentum of change occurring in group treatment sessions. METHOD: Therapists in this model use words and phrases depicting the group as a body in order to guide the treatment process and develop between-session prescriptions. Maintaining a perspective of the treatment group as a body facilitates development of member commitment to the well-being of a physical and psychological body, and between-session assignments employ the developmental phases of the therapy for illuminating the disorder and effecting its resolution. This approach was developed in an ongoing, open-ended treatment group provided at a community mental health center for 14 years. RESULTS: Examples are presented of process prescriptions which simultaneously address several dynamic levels: (a) the theme of interactions between the individuals in each session; (b) the particular stage of the group's development, and the ways this level of maturation determines how interactions arise and themes are selected; and (c) the underlying functions of the eating disorder. DISCUSSION: Using the metaphor of the body to guide the language of between-session prescriptions links developmental group treatment process with members' day-to-day engagement with the eating disorder. By participating directly in the development of the treatment experience, the group members become committed to a developmental process that engages them in accountability and caring for a body, and, by extension, their own bodies.

Adult↗
PubMed1997

Implementing an informatics system in a perioperative environment.

This article identifies and describes strategies for successful implementation of an informatics system in a perioperative environment. With the trend toward managed care, perioperative nurses must address the challenge of instituting advanced technology in organizations with limited staffing and other resources. Planning methods of the past no longer are relevant in today's health care systems; therefore, innovative planning approaches are important. Five key elements in implementation of an informatics system are: a collaborative planning process, education and involvement of staff members regarding the systems design, development of a timetable, selection of a focus group, and assessment of staff members' training requirements. Methods are described for using a focus group process, including recommendations for structuring the focus group and establishing responsibilities of core group members.

Computer User Training↗
PubMed2005

Navigating the journey to menses cessation: a study of change in an emancipatory context.

PURPOSE: This article explores contemporary women's perceptions of the experience of the menopausal process within the Western industrialized culture, describes and synthesizes the processes used by women to evaluate available information, and explores and facilitates processes used by women to envision and create change in their life world. METHOD: An emancipatory group process was designed to facilitate dialogue between the investigator and nine women who met as a group eight times during a 10-week period in the home of one of the participants. FINDINGS: Participants identified menses cessation as a time of change in all aspects of their lives. They employed decision making to cope with these changes and, as a result of the awareness that came through the research process, invited other women to celebrate the collective wisdom of women at all stages of life. CONCLUSION: Women experiencing menses cessation need information and time to process that information internally and in relation with others. IMPLICATIONS: Nurses can facilitate the process by providing knowledge, assisting women in decision making, and intervening in ways that contribute to a holistic quality of life for women.

Adaptation, Psychological↗
PubMed1990

Effect of aflatoxin B1 on resistance induced by Bordetella bronchiseptica vaccine in rabbits.

The effects of aflatoxin B1 on the development of the immune response to oil-adjuvanted Bordetella bronchiseptica vaccine and on acquired resistance to bacterial challenge were studied in rabbits. The doses of aflatoxin used were insufficient to produce clinical intoxication. Rabbits were randomly assigned to three groups, each having six animals: control (T), vaccinated (V), and vaccinated plus aflatoxin (VA) at 0.05 mg/kg daily per os. Groups V and VA were vaccinated twice, and the three groups were subsequently challenged with virulent B. bronchiseptica. The average weight gain at weekly intervals was significantly reduced in group VA, and no statistically significant differences were found in the titers of agglutinating antibodies between groups V and VA. There were significant differences between groups V and VA in the extent and severity of the pneumonic process, group VA being most affected. Results indicated that agglutinating antibody titers were not related to the level of protection in the latter group. Other mechanisms, such as alveolar macrophage activity and cell-mediated immunity, were implicated in the impairment of the acquired resistance in rabbits subclinically intoxicated with aflatoxin.

Aflatoxin B1↗
PubMed2000

A qualitative evaluation of an assisted self-help group for drug-addicted clients in a structured outpatient treatment setting.

We conducted a qualitative evaluation of a semi-structured, client-led support group that addressed drug use recovery issues and was assisted by a psychological consultant. Seven regular group members and their counselors were interviewed about the effect of the assisted self-help group on drug use and the clients' quality of life, and these interviews were content analyzed. In addition, the psychological consultant made group process observations for each session of the first three months. Clients reported group strengths as: Feeling supported and understood, being able to speak freely without fear of staff reprisals, obtaining information/feedback, improved mood, and decreased drug use. With the provision of professional support and guidance, this group shows promise as an adjunct to standard outpatient drug abuse treatment by allowing for some degree of client independence and extending the scarce resource of professional counseling.

Counseling↗
PubMed1999

Evaluation of reflective learning in a psychodynamic group of nurses caring for terminally ill patients.

The development of a psychodynamic group comprising seven female nurses was studied for 1 year (31 sessions). The group was part of a 1-year postgraduate training in patient-centred nursing. The members of the group all worked on the same unit; none of them left the unit or the group during the study. As the nurse-patient relationship is considered to be crucial for patient-centred nursing, the group sessions focused on the problems which the nurses experienced in their relationships with the patients. The objective of the group-work was to improve the nurses' ability to reflect on these relationships. The purpose of the study was to evaluate the group sessions, concentrating on the characteristics of patients selected for discussions, group process over time, and impact of specific patient characteristics on the group-work. Transcriptions of the tape-recorded group sessions were made for systematic analysis. A category system was developed and validated to rate reflection about the patient, the nurses themselves and the nurse-patient relationship. The results showed that the nurses over-proportionally selected terminally ill patients, as well as patients who were female and within a similar age range as themselves. These results could be due to an identification with these patients, causing increased psychological stress on the nurses. Throughout the year, the nurses' verbal activity and their reflections about their patients increased, whereas their reflections about themselves decreased. The need to withdraw and protect oneself by focusing more on the patient than on oneself might have been a strategy the nurses used to cope with growing stress.

Adult↗
PubMedDate not supplied

Studies of respiratory morbidity in rubber workers. Part III. Respiratory morbidity in processing workers.

Respiratory questionnaires and pulmonary function tests were administered to sixty-five men exposed to dust in the processing are from three rubber tire manufacturing plants. Similar tests were done on 189 "control" workers. Compared with the controls, the processing workers had a higher prevalence of chronic productive cough. Overall, the processing group showed a decrease in the ratio of FEV to FVC. The processing workers with more than ten years of exposure showed a significant decrease in the ratio of FEV1.0/FVC, the FEV1.0, the residual FEV1.0, and the flow rates at 50% and 25% of the forced vital capacity. None of the pulmonary function effects could be solely explained on the basis of smoking, age, ethnic, or socioeconomic factors: all were related to the length of exposure. Based on these results we conclude that exposure in the processing area produces pulmonary disease.

Adult↗
PubMed1998

"Bipolar groupthink": assessing groupthink tendencies in authentic work groups.

Research on regressive group processes such as Janis' (1982) "groupthink" phenomenon has rarely focused on work groups in authentic settings. In this study, teams from six different organisations (n = 308) were studied by using a groupthink questionnaire constructed in accordance with the symptoms of groupthink described by Janis. It was hypothesised that groupthink could be described as a bipolar construct identifying either an omnipotent or a depressive variant of a group's delusions about its own and other groups' features. The questionnaire showed reasonably good reliability as a whole and a factor analysis identified three factors in line with the proposed theoretical model in which the two different types of groupthink can be distinguished. We propose that any group might have a tendency or predisposition to react in either of the two directions during provocative circumstances. The six different organisations exhibited different types of groupthink to a varying degree. A religious sect was the one most characterised by omnipotent groupthink, while a technological company and a psychiatric team seemed to be the ones with most features of depressive groupthink.

Bipolar Disorder↗
PubMed1978

Encounter and psychotherapy: a look at the overlap.

Human relations training has moved from the original T-group emphasis on group process, through focusing on the individual's mode of interacting in the group, to the use of the encounter situation for fostering personality change. Psychotherapy is moving out of the dyadic relationship into groups using increasing degrees of confrontation. The resulting overlap in group techniques calls for examination of the part each can play in the overlap area between the clear-cut functions of each specialty. The theoretical basis for differentiation lies in the respective models of awkward ("neurotic") behaviour: psychotherapy starts from the pathological and emphasizes intrapersonal structure, while encounter starts from full-functioning behaviour and emphasizes interpersonal interaction. Practical responsibilities can be divided between encounter and psychotherapy on the basis of the level achieved by an individual moving through a hierarchy of ascending personal achievement levels. Because of the high probability of individuals interchanging between encounter and psychotherapy, practitioners will need to have at least basic knowledge of both systems. Rapprochement could eventually come through the systematic extension of existential psychotherapy.

Humans↗
PubMed1976

Volunteer adolescents in adolescent group therapy. Effects on patients and volunteers.

The effects on patients, volunteers and staff of using volunteer adolescents in adolescent group therapy are examined. From 40 candidates eight volunteers were selected and oriented to the group process. Four volunteers and four patients were placed in each of two groups, and eight patients were placed in the third group. Patients and volunteers were aware of their identities in the first group session. Attendance in the groups with volunteers was better than in the group without. The volunteers themselves gained new knowledge and skills, and their presence was even helpful to the group leaders.

Adolescent↗
PubMed1999

[Support groups for patients in the early stage of dementia--usefulness and experiences].

In recent years, support groups focusing on education, sharing of experiences, coping strategy development, and group process have been recognized as a valuable psychosocial intervention for people in the early stage of dementia. Outcome research has shown that support groups have positive effects on participants' understanding of the disease and its consequences, their coping behavior and general wellbeing. Leading support groups for this population requires an extensive knowledge about the disease process and counseling experience. Clinicians are asked to support all efforts to establish more support groups because they are complementary to already existing treatments.

Aged↗