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PubMed1979

Training in anger: how not to communicate with one's medical seniors.

Meyer and Mendelson (2) have identified four critical situations which influence the interaction of consultant and consultee, namely, (1) inappropriate setting; (2) threat through disease and death; (3) character disorders; (4) family and social pathology. Feeling states of hopelessness, pessimism and despair are induced in both consultant and consultee and may lead to a breakdown of their working alliance. It is postulated that the breakdown is programmed by the physicians' basic attitudes towards coping with dependency needs are ignored by the faculty of not being patient-oriented (5). Covert or open hostility towards the faculty is manifested (10). Basic professional needs are not discussed with one's medical seniors who are seen in anger. If liaison medicine is to become effective, its proponents have to direct their attention towards attitudinal learning during undergraduate study. This will require supervised exposure to patients needs, assuming increasing responsibility, individual and faculty feedback.

Anger↗
PubMed1980

Measurement of the type A behavior pattern in children: assessment of children's competitiveness, impatience-anger, and aggression.

The results of a program of research designed to produce an adequate measure of the type A behavior pattern in children are reported. The type A pattern is a risk factor for heart disease in adulthood and is characterized by extremes of competitiveness, impatience, easily aroused anger, and aggression. A questionnaire called the Matthews Youth Test for Health (MYTH-Form O) contains 17 statements that characterize pattern A behaviors in children. Study 1 was conducted to provide psychometric data for the MYTH. Teachers rated how well these statements characterized 485 children enrolled in grades K, 2, 4 and 6. Those children remaining in the school district 3 months later (N = 420) were rated again. Statistical analyses of these ratings suggest that the MYTH-Form O is a reliable, internally consistent instrument, which yields 2 orthogonal factors: competitiveness and impatience-aggression. As expected, there were substantial gender differences in children's type A behavior. Study 2 tested the construct validity of the MYTH in a subsample of children who were challenged to win a car race against an experimenter; were given an opportunity to play with a variety of toys, including a plastic Bobo doll; and were asked to execute a frustrating task during 1 session. Results showed that type A's won a race against a female (not a male) experimenter by a larger margin than did type B's. Type A's aggressed against a Bobo doll earlier and were more impatient than were type B's throughout the session. These impatient behaviors exhibited by child type A's are similar to those exhibited by adult type A's during the standardized adult type A interview. In sum, these data are supportive of the reliability and validity of the MYTH and represent a first step in the development of an instrument to assess pattern A in elementary school-aged children.

Aggression↗
PubMed1998

Assessing and intervening with anger disorders.

Nurses often find angry patients threatening. In this article, current research will be synthesized to provide guidance to nurses whose specialty area may not be psychiatric nursing. Guidelines for assessing and intervening with angry clients will be provided. Such guidelines are likely to be useful to nurses in every clinical setting, from the emergency room to the rural clinic to the high-tech hospital unit. Nurses will also learn some techniques for managing their own anger at uncooperative or hostile clients.

Adaptation, Psychological↗
PubMed1998

Fear and anger regulation in infancy: effects on the temporal dynamics of affective expression.

Emotion regulation has been conceptualized as the extrinsic and intrinsic processes responsible for monitoring, facilitating, and inhibiting heightened levels of positive and negative affect. Regulation of distress is related to the use of certain behavioral strategies. Our study examined whether putative regulatory behaviors widely assumed to be conceptually associated with these strategies are actually empirically associated with the changes in fearful and angry distress in 6-, 12-, and 18-month-old infants. Our key finding was that the use of some putative regulatory behaviors (e.g., distraction and approach) reduced the observable intensity of anger but were less effective in reducing the intensity of fear. The results suggest (1) caution in assuming that postulated regulatory behaviors actually have general distress-reducing effects and (2) the likelihood that "distress" is too global a construct for research on emotion regulation.

Adaptation, Psychological↗
PubMed1977

Anger camera imaging of perfused and nonperfused brain tissue with intra-arterial 133Xenon technique.

The regional cerebral blood flow, the regional blood flow distribution, and the regional distribution of perfused (= vital) brain tissue been imaged with a digitalized conventional Anger camer. An analog scaler was placed behind the PM-tubes to reduce dead-time loss. The input pulse rate was doubled to counteract the effect of scaling on counting statistics, and the gamma emission was filtered through 1 mm of brass to increase the fraction of the integral count rate within the 40% window. In this way the 31 keV peak disappears, and Compton scatter and disturbing coincidences are markedly reduced. This improves spatial resolution. The flow parameters are imaged regionally in 3 X 3 mm2 matrix elements after flat field correction and smoothing. The matrix is 64 X 64 interpolated to 128 X 128. Patient studies emphasized the importance of imaging the distribution of perfused and nonperfused tissue in cases of infarctions, dilacerations, etc., where angiography and conventional brain scanning may often be negative.

Adult↗
PubMed2006

Does village inequality in modern income harm the psyche? Anger, fear, sadness, and alcohol consumption in a pre-industrial society.

Researchers have found a positive association between income inequality and poor individual health. To explain the link, researchers have hypothesized that income inequality erodes community social capital, which unleashes negative emotions, stress, and stress behaviors that hurt health. Few studies have tested the hypothesized path. Here we estimate the association between (a) village income inequality and social capital, and (b) three distinct negative emotions (anger, fear, sadness) and one stress behavior (alcohol consumption). We use four quarters of panel data (2002-2003) from 655 adults in 13 villages of a foraging-farming society in the Bolivian Amazon (Tsimane'). We found that: (1) village income inequality was associated with more negative emotions but with less alcohol consumption, (2) social capital always bore a negative association with outcomes, and (3) results held up after introducing many changes to the main model. We conclude that village income inequality probably affects negative emotions and stress behaviors through other paths besides social capital because we conditioned for social capital. One such path is an innate dislike of inequality, which might have pre-human origins. Our prior research with the Tsimane' suggests that village income inequality bore an insignificant association with individual health. Therefore, village income inequality probably affects negative emotions and stress behaviors before undermining health.

Adult↗
PubMed1996

[Urinary tract abnormalities with prenatal diagnosis: neonatal management and outcome of 100 children born 1988-1990 at the Angers CHU (University Hospital)].

UNLABELLED: Malformative uropathies diagnosed in utero are increasing in number. This work describes the decision strategy adopted in Angers concerning the neonatal handling of those abnormalities. PATIENTS AND METHODS: One hundred children born between 1988 and 1990, with prenatally suspected fetal uropathy, were included in the study and followed for a period of 3 years. In every case, an ultrasound scan was performed at birth. In cases with persistent abnormality, a voiding cystourethrography was done in the first week of life. An intravenous urograph and/or a nuclear renography were performed during the second month of life. RESULTS: Twenty-nine children were normal. Seventy-one were affected by 126 isolated or related uropathies; the most frequent ones were the ureteropelvic junction obstruction syndrome (48), ureterovesical junction obstruction (18) and multicystic kidneys (13). A vesicoureteral reflux was associated in 22% of cases. The diagnosis was perfectly correlated with the prenatal diagnosis in 50% of cases. Fourteen of the normal children had a later ultrasound scan control, between 2 and 9 months; later on, three of them showed a moderate ureteropelvic junction obstruction syndrome. Amongst the 48 ureteropelvic junction obstruction syndromes, 22% have been operated on. The others obstructive uropathies remained stable or spontaneously improved. DISCUSSION: These results require us to discuss as matter of priority the large number of spontaneously regressive prenatal hydronephrosis and the necessity to establish a consensus for the pre and postnatal pathological thresholds of the anteroposterior pelvic diameter, the interest in carrying out a voiding cystography after the birth when dilatation is confirmed, the interest of nuclear renography for the diagnosis and follow-up of obstructive uropathies and the absence of urgency for surgery. CONCLUSION: We propose a decision tree specifying the action to take when facing the diagnosis of a prenatal hydronephrosis. It could be a part of the reflection for the medical teams handling these uropathies is the aim of a consensual attitude which is now essential.

Disease Management↗
PubMed1975

[Measurement of renal blood flow with the Anger scintillation camera after selective intra-arterial injections of 133xenon and 99mtechnetium].

A "region of interest" technique for measuring renal blood flow is described, using as Anger camera and selective intra-arterial injection of 133Xe and 99mTc. The sequence of measurements has the advantage of providing information on regional blood flow. The values for RBF and RBFD obtained with 133Xe agree with those in the literature. Selective determination of the RCBF with the "region of interest" technique using 133Xe was not possible. Mean transit time for 99mTc was calculated after correction of the 99mTc indicator dilution curve with respect to recirculation and background activity. All typer of pathological changes in the kidney showed a statistically significant increase in mean transit time when compared with a control group. In patients with uncomplicated essential hypertension, the mean transit time was signigicantly reduced. A comparison of the mean transit time of 99mTc with the haemodynamic parameters derived from the 133Xe studies, and experiments with pharmocologically induced vasoconstriction indicates that the mean transit time represents a measure of the RCBF.

Adolescent↗
PubMed1979

The Anger camera and the pertechnetate ion in the routine evaluation of thyroid uptake and imaging.

The thyroid traps the pertechnetate ion and iodine in a similar manner. Thus, 99mTc-pertechnetate may be used for thyroid uptake studies (including stimulation and suppression tests)8 as well as imaging. Images are obtained after an intravenous administration of 2--4 mCi of 99mTc-pertechnetate, and the scan is preceded by a trapping index at 20 minutes, measured as the neck to thigh ratio. In 1973, we compared 99mTc-pertechnetate with 131I in diagnostic uptake and imaging studies of the thyroid gland in 100 patients. We have had experience with an additional 100 patients, and modified our procedure so that the Anger camera with pinhole collimator will adequately replace the standard scintillation probe. Using the camera alone, with the 99mTc-pertechnetate makes the study less expensive and briefer, with no loss of information. Routine use of the scan aids in distinguishing diffuse from localized diseases.

Evaluation Studies as Topic↗
PubMed1979

An evaluation of the 24-hour RAIU test performed with an Anger camera and a pinhole collimator.

RAIU measurements obtained with a conventional thyroid uptake probe have been compared with those obtained with an Anger camera and a pinhole collimator. Although the field distribution for the pinhole collimator deviates markedly from the IAEA recommendations, the group data from the comparative measurements in this series were identical, with a confidence level of 99%. However, in several cases the data from differing measurement regimes for individuals varied markedly.

Humans↗
PubMed1998

Deadtime correction for two multihead Anger cameras in 131I dual-energy-window-acquisition mode.

Two side-by-side energy windows, one at the photopeak and one at lower energy, are sometimes employed in quantitative SPECT studies. We measured the count-rate losses at moderately high activities of 131I for two multihead Anger cameras in such a dual-window-acquisition mode by imaging a decaying source composed of two hot spheres within a warm cylinder successively over a total of 23 days. The window locations were kept fixed and the paralyzable model was assumed. In addition, for the Picker Prism 3000 XP camera, the source was viewed from three different angles separated by 120 degrees and the final results are from an average over these three angles. For the Picker camera, the fits to the data from the individual windows are good (the mean of the squared correlation coefficient equals 0.98) while for the Siemens Multispect camera fits to the data from head 1 and from the lower-energy, monitor window are relatively poor. Therefore, with the Siemens camera the data from the two windows are combined for deadtime computation. Repeated autopeaking might improve the fits. At the maximum count rate, corresponding to a total activity of 740 MBq (20 mCi) in the phantom, the multiplicative deadtime correction factor is considerably larger for the Picker than for the Siemens camera. For the Picker camera, it is 1.11, 1.12, and 1.12 for heads 1-3 with the photopeak window and 1.10 for all heads with the lower-energy monitor window. For the Siemens camera, the combined-window deadtime correction factor is 1.02 for head 1 and 1.03 for head 2. Differences between the deadtime correction factor for focal activity and for the total activity do not support the hypothesis of count misplacement between foci of activity at these count rates. Therefore, the total-image dead time correction is recommended for any and all parts of the image.

Equipment Design↗
PubMed1976

Brain scanning with the Anger multiplane tomographic scanner as a second examination evaluation by the ROC method.

One hundred and one patients (43 abnormal, 58 normal) were re-examined with a commercial prototype of the Anger multiplane tomographic scanner after brain scintigraphy. The studies were interpreted independently by four observers of varying experience. Observer performance, in terms of ROC curves, was substantially better when interpreting the tomographic brain scans and camera scintigrams together or the tomographic scans alone than when interpreting the camera images alone. Re-examination with the scanner increases the accuracy of brain scintigraphy (observer performance) in cases in which there is difficulty distinguishing intracranial lesions from superficial foci of activity by camera scintigraphy alone.

Brain Neoplasms↗
PubMed1976

Brain scanning with the Anger multiplane tomographic scanner as a primary examination. Evaluation by the ROC method.

A commercial prototype of the Anger multiplane tomographic scanner was compared with a scintillation camera, in terms of observer performance, as a primary instrument for brain scintigraphy. Observer performance (diagnostic accuracy), expressed as ROC curves, was slightly better when reading the tomographic scans than when reading the camera images. In brain scintigraphy of a general population, the scanner has a small advantage over the scintillation camera. This advantage is directly proportional to the fraction of cases in which there is difficulty differentiating intracranial lesions from superficial foci of activity on the camera image.

Brain Neoplasms↗
PubMed1998

Modulation of Anger and Aggression.

Traumatic brain injury commonly results in anger and aggressive behavior. The hypothalamus, limbic system, and prefrontal cortex mediate aggression, and frequently are injured during trauma. Many neurotransmitters that modulate aggressive behavior, including norepinephrine, serotonin, dopamine, and acetylcholine are affected by brain injury. The pharmacological treatment of aggression is divided into medications used for acute behavioral control, and those used for the prophylaxis of episodes. Specific recommendations are made for the choice of specific medications.

Journal Article↗
PubMed1975

Deadtime characteristics of Anger cameras.

The deadtime characterisitcs of Anger cameras are analyzed from theoretical and experimental points of view. An investigation of two Searle Radiographics cameras revealed that they had both paralyzable and nonparalyzable components, the deadtimes of which varied with analyzer window width, the energy of the gamma rays counted, and the position of the "time constant selector" switch in the A-scope module of these cameras. A mathematical model for two-component systems is presented.

Evaluation Studies as Topic↗
PubMed1975

Digital tomographic imaging with time-modulated pseudorandom coded aperture and Anger camera.

The properties of a time-modulated pseudorandom coded aperture with digital reconstruction are compared with those of conventional collimators used in gamma-ray imaging. The theory of this coded aperture is given and the signal-to-noise ratio in an element of the reconstructed image is shown to depend on the entire source distribution. Experimental results with a preliminary 4 X 4-cm pseudorandom coded aperture and an Anger camera are presented. These results include phantom and human thyroid images and tomographic images of a rat bone scan. The experimental realization of the theoretical advantages of the time-modulated coded aperture gives reason for continuing the clinical implementation and further development of the method.

Radionuclide Imaging↗
PubMed1976

Methods of correcting Anger camera deadtime losses.

Three different methods of correcting for Anger camera deadtime loss were investigated. These included analytic methods (mathematical modeling), the marker-source method, and a new method based on counting "pileup" events appearing in a pulse-height analyzer window positioned above the photopeak of interest. The studies were done with 99mTc on a Searle Radiographics camera with a measured deadtime of about 6 musec. Analytic methods were found to be unreliable because of unpredictable changes in deadtime with changes in radiation scattering conditions. Both the marker-source method and the pileup-counting method were found to be accurate to within a few percent for true counting rates of up to about 200 K cps, with the pileup-counting method giving better results. This finding applied to sources at depths ranging up to 10 cm of presdwood. The relative merits of the two methods are discussed.

Radionuclide Imaging↗