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Words that touch.

In this paper the author examines her own use of language as a psychoanalyst and asks: what is the best way to help analyse and to find the words to express not only what they are thinking but also what they are feeling and experiencing? In common with other psychoanalysts, the author has observed that each of us simultaneously utilises both advanced psychic mechanisms that are accessible to symbolism and more archaic ones, which are less so. However, she draws a distinction between people who are able to tolerate the perception of their own heterogeneity, even if it is sometimes a source of suffering, and those whom she terms 'heterogeneous patients'. Patients in the latter category, whose lack of internal cohesion causes them anxiety, are afraid of losing their sense of identity. The author asks how we can understand their language and how we should speak to them. She uses several clinical examples to demonstrate that 'heterogeneous patients' need to be touched with a language that does not confine itself to imparting thoughts verbally but also conveys feelings and the sensations that accompany those feelings. It is also an 'incarnated' language because the words pronounced by the analyst can awaken, or reawaken, bodily fantasies in the patient. These words may enable him to find an emotional meaning in forgotten sensory or bodily experiences, which may then become a starting point for his work of thinking and of symbolisation.

Adult↗

Self-report of drinking using touch-tone telephone: extending the limits of reliable daily contact.

OBJECTIVE: Retrospective self-reports of alcohol consumption are ubiquitous in the alcohol research field. Time frames of these reports range from a week to a year or longer and are subject to several influences of bias that may have important clinical, epidemiological and methodological consequences. In order to specify drinking patterns more precisely, a study was conducted to monitor alcohol consumption on a daily basis. METHOD: Subjects (N = 51) responded for 112 days on an Interactive Voice Response system by entering their data daily using the touch-tone pad of their telephone. Each day, subjects answered 11 questions relating to drinking (including quantity) and to variables believed to affect consumption (e.g., stress level). RESULTS: The overall response rate was 93.0%. Subjects reported consuming at least one drink on 51.2% of all 5,151 reporting days (mean number of drinks reported = 4.6). Following completion of the study, subjects were also asked to recall consumption retrospectively using a standard quantity-frequency questionnaire. CONCLUSIONS: The present study demonstrated that: (1) data can be collected on a daily basis efficiently, and (2) traditional methods of data collection (e.g., quantity-frequency) result in a significant underreporting bias for heavier drinkers.

Adult↗

A touch-detecting teaching machine with auditory reinforcement.

This teaching machine has been designed and used to train reading and other visual discrimination skills with normal and retarded children. On each frame the subject responds by touching one of three response panels on which are projected the multiple-choice alternatives. The response panels are coated with a transparent conducting film which allows electronic detection of this simple and direct response. Correct responses are reinforced by the machine naming the stimulus, while auditory reinforcement is absent for an incorrect response. The subject's performance level is continuously computed as an exponentially weighted moving average. The measure is weighted so that it rapidly follows recent changes in performance.

Journal Article↗

Stimulus control in the use of landmarks by pigeons in a touch-screen task.

Pigeons were tested in a search task on the surface of a monitor on which their responses were registered by a touch-sensitive device. A graphic landmark array was presented consisting of a square outline (the frame) and a colored "landmark." The unmarked goal, pecks at which produced reward, was located near the center of one edge of the frame, and the landmark was near it. The entire array was displaced without rotation on the monitor from trial to trial. On occasional no-reward tests, the following manipulations were made to the landmark array: (a) either the frame or the landmark was removed; (2) either one edge of the frame or the landmark was shifted; and (3) two landmarks were presented with or without the frame present. On these two-landmark tests, the frame, when present, defined which was the "correct" landmark. When the frame was absent, the "correct" landmark was arbitrarily determined. Results showed that pecks of 2 pigeons were controlled almost solely by the landmark, pecks of 3 were controlled primarily by the landmark but the frame could distinguish the correct landmark, and 1 bird's behavior was controlled primarily by the frame. Stimulus control in this search task is thus selective and differs across individuals. Comparisons to other search tasks and to other stimulus control experiments are made.

Journal Article↗

Interferometry: a new method for no-touch measurement of the surface and volume of ulcerous skin lesions.

A new interferometry procedure (Holon View measuring system) permits non-invasive and objective measurement of the surface, height/depth and volume of ulcerous lesions. The method, which uses a combination of the so-called phase-shift and gray-code technique, is new in dermatology. The measuring system consists of a diffraction grating projection system, a video camera and a computer-aided, digital image processing and analysis system. A diffraction grating consisting of 320 lines is projected onto the skin surface or a silicone impression of the ulcerous lesion. The course of the light-intersection lines is recorded by a video camera and read into an image computer. The special feature of the method is the combination of grey-code projection and a phase-shift procedure. For evaluation of the method in dermatology, 2,000 interferometric measurements of volume were carried out on objects of known volume, on silicone impressions and on leg ulcers. The accuracy of the method has been proven by means of the evaluation of objects of known volume. The results of interferometric measurements were compared with the values of the volume determined by water capacity and those of the surface determined by image analysis. The healing of a leg ulcer was followed over an 8-week period. The Holon View measuring system permits no-touch measurement of the volume and surface of ulcerous skin lesions with a high degree of accuracy and precision, in a short time.

Body Water↗

Eigenvectors of the inertia tensor and perceiving the orientation of a hand-held object by dynamic touch.

Subjects wielded an object, hidden from view, and reported the orientation in which the object was positioned in the hand. The object consisted of a stem with two branches forming a V attached perpendicularly to the stem's distal end. The branches were differentially weighted so that the same spatial orientation of the object was associated with different orientations of its principal (symmetry) axes or eigenvectors. Perceived orientation was found to be dependent on the eigenvectors of the object's inertia tensor, computed about the point of rotation in the wrist, rather than on its spatial orientation. The results underscore the significance of the inertia tensor to understanding the perception of spatial properties by dynamic touch.

Adult↗

Interpretative problems and preparative technique influence reliability of intraoperative parathyroid touch imprints.

CONTEXT: Identification of parathyroid tissue (PT) is crucial during parathyroid and thyroid surgery. Touch imprint preparation (TIP) examination is potentially a more time-effective and less labor-intensive approach than frozen section examination for identification of PT during intraoperative consultation. However, the reliability of PT-TIP remains controversial, and this fact has hindered its adoption as a replacement for frozen section examination. OBJECTIVE: To assess the factors contributing to the relative lack of reliability of TIP in a retrospective study. METHODS: Fifty randomly selected, alcohol-fixed, hematoxylin-eosin- and/or Diff-Quik-stained TIPs of specimens that had been submitted to confirm PT during intraoperative consultation were retrospectively reviewed by 5 observers. The observers were blinded to the final interpretation (based on hematoxylin-eosin-stained permanent sections), which included PT in 39 (78%) of the 50 specimens, thyroid in 9 (18%), lymph node in 1 (2%), and adipose tissue 1 (2%). Cases in which a unanimous diagnosis was not attained were re-reviewed by 3 observers. RESULTS: Of 50 TIPs reviewed, a unanimous diagnosis was rendered in 33 cases (66%), including 27 (69%) of 39 PT cases, 5 (56%) of 9 thyroid cases, and the 1 lymph node case. Cytologic features observed in the TIPs that were unanimously accepted as being diagnostic of PT included the presence of small uniform cells in isolation or in small groups, round to oval nuclei, salt-and-pepper chromatin, occasional naked nuclei, and delicate vacuoles both within the cytoplasm and in the background. Re-review of the 17 remaining TIPs cases, in which diagnostic unanimity was not achieved, demonstrated that factors hindering assessment of the TIPs included hypocellularity (n = 5 cases), air-drying effect (n = 4), hemorrhagic background (n = 4), and presence of PT cells in follicular (thyroid-like) arrangements (n = 4). CONCLUSIONS: The major factors influencing reliability of TIP of PT during intraoperative consultation are related primarily to interpretative problems and preparative technique. Awareness of interpretative problems and attention to preparation of TIPs may further enhance the accuracy of TIP during intraoperative consultation.

Cytodiagnosis↗

High-tech, high-touch perinatal home care.

Perinatal home care for women experiencing a high-risk pregnancy often requires the use of technologies for safe home management. Home care professionals need to integrate high technology with high touch to ensure the best results.

Community Health Nursing↗

The growth cycle of influenza viruses as studied in touch preparations of the allantoic layer of chick embryos. 3. The growth cycle of influenza A virus in allantoic cells as studied by immunofluorescence.

The growth cycle of Influenza A virus has been studied in touch preparations of infected allantoic layers of the chick embryo using the immunofluorescence technique. Eggs incubated for 11 days were inoculated with either of two comparative doses: (A) 10(9)ID50 (high multiplicity) and (B) 200 ID50 (low multiplicity). (A) After inoculation of 10(9)ID50 (multiplicity: 100ID50 to 3 cells) into the allantoic cavity, two closely associated cycles of infection were observed. (a) A single cycle of multiplication which occurred simultaneously in all cells (those in contact with the allantoic fluid) of the surface stratum of the allantoic layer and terminated with their degeneration followed by desquamation at around the 18-21st hour after inoculation. Consequently, the cells of the deep stratum, denuded of surface stratum, came into contact with the allantoic fluid, a fluid heavily infectious. This first infectious process is termed the major growth cycle. (b) Multiple cycles of infection which occurred in only about 1-5% of cells of the deep stratum of the allantoic layer, the other 95% of deep cells remaining constantly free from infection. This condition is referred to as the minor growth cycle and it lasted until death of the embryos occurred within a maximum of 6-7 days after inoculation.

Allantois↗

The growth cycle of influenza viruses as studied in touch preparations of the allantoic layer of chick embryos. 2. The morphology of allantoic cells infected by influenza A virus.

The morphology of allantoic cells infected by influenza A virus was studied in touch preparations of the allantoic layer from 11-day embryos inoculated by the intra-allantoic route. Two comparative doses were used: 10(9) ID50 or large inocula (multiplicity: 100 ID50 to 3 cells) and 200 ID50 (multiplicity: 1 ID50 to 150,000 cells) or small inocula. The allantoic layer from 11-day eggs is an epithelium consisting of at least two strats: a superficial stratum and a deep one. Both with the large and the small inocula, a total and irreversible destruction of the superfifial stratum (cells having free facets in ocntact wit- allantoic fluid) was produced, while the profound one (a layer underlying the surface stratum, with cells normally not having any contact with the allantoic fluid) remained essentially intact. Three successive stages were observed. 1. Incubation period: The cells of both strata exhibited a normal appearance during the first 10 hours with the higher multiplicity, and for the first 15-17 hours with the lower multiplicity. 2. Necrotic period: The cells of the superficial stratum exhibited degenerative changes (the chromatin breaks up into numerous irregular and deeply stained fragments) followed by desquamation into the allantoic fluid within the next 10 hours (from 10th to 20-22th hour after inoculation) with the large, and the next 17 hours (from 15th-17th to 32nd-34th h.) with the small inocula. No morphological changes were observed with the profound cells. 3. Post-necrotic period: The profound stratum with cells of sound appearance, some of whoch showed giant nuclei (polyploid cells?) REMAINED UNTIL THE DEATH OF THE EMBRYos which occurred within a maximum of 6-7 days after inoculation. Occasionally, throughout this period, degenerated deep cells were found (about 1-5% in quantity) which, with the aid of immunofluorescence procedure, are believed to be related to a minor cycle of virus multiplication.

Allantois↗

Skin rejuvenation with cool touch 1320 nm Nd:YAG laser: the nurse's role.

Nonablative laser remodeling with the Cool Touch system is a new skin-rejuvenation procedure. Nurses play several valuable roles in educating and caring for patients undergoing this procedure including assisting with patient selection, preoperative preparation, intraoperative set up and delivery, postoperative care, and followup.

Aftercare↗

The growth cycle of influenza viruses as studied in touch preparations of the allantoic layer of chick embryos. 4. The growth cycle of influenza B virus: presence of basophilic inclusions in cytoplasm of CAM epithelial cells.

The infectious cycle of Influenza B virus occurring at the allantoic layer of embryonated eggs has been studied by means of cytological and immunofluorescence techniques utilizing touch preparations. The infectious cycle of the virus resembles closely that of Influenza A virus. Influenza B virus, regardless of the dose inoculated, affected the strata of the allantoic layer to a different extent. It totally destroyed the surface stratum (major growth cycle) in about 20 hours time when a 10(8) ID50 dose was inoculated and within 38 hours with a 10 ID50 dose. In the deep stratum, which remained denuded after the destruction of the surface one, most cells (90%) showed normal appearance and a small proportion (about 10%) appeared to be infected. This condition of a minor growth cycle of infection lasted till death of the embryos which occurred within 3--4 days as a maximum. At advanced stages of infection ulcerations (loss of epithelium) appeared which at no time were observed in a Influenza A virus infection.

Animals↗

Leadership in the digital age: a framework to balance high touch with high tech.

The next great age will be influenced heavily by the physical sciences, biological sciences, and nanotechnologies. This article presents case scenarios highlighting the technologic possibilities for the next age. It also presents a potential leadership model for the digital age and beyond. Finally, it provides insight as to how nurse managers can reconcile one of the major dilemmas in nursing--balancing "high touch" with "high tech."

Conflict, Psychological↗

Baby massage: a dialogue of touch.

The significance and benefits of touch and massage for preterm infants in Neonatal Intensive Care Units and in the community are discussed. The article emphasises the value of massage in helping parents to bond with their baby and as part of family-centred care. A bibliography is included.

Bibliographies as Topic↗

Increasing touch between parents and children with disabilities: preliminary results from a new programme.

Initial findings are presented from a specially devised touch therapy programme for parents of children with disabilities. A total of 42 parent children have completed the programme. Therapists teach parents simple massage techniques during one-hour sessions held once a week for eight weeks. The children had a range of disabilities including cerebral palsy, asthma, sensory impairments and Down's syndrome. Parents reported improvements in children's muscle tone, joint mobility, sleep patterns, bowel movements and response to other forms of therapy, e.g. physiotherapy. Parents also reported that they themselves had benefited, e.g. by feeling "closer" to their child and less stressed.

Adolescent↗

Clinical evaluation of a 15% in-office hydrogen peroxide tooth-whitening touch-up agent.

The success of tooth whitening has increased public demand for quicker results of the tooth-whitening process. More and more patients are opting for in-office treatments, if available, to expedite the process, and they are looking for ways to re-whiten quickly when they feel their teeth have reverted from their after-treatment results. This article will discuss the use of a commercially available product as a touch-up procedure for patients who had been previously treated with a 2-week carbamide peroxide whitening regimen.

Adolescent↗