An exploration into the client at the heart of therapy : a qualitative perspective

Over 50 years ago Eysenck challenged the existing base of research into psychotherapy. Since that time, a large number of investigations have been conducted to verify the efficacy of therapy. Recently however, an increasing number of studies have cast new doubts on this research base. Instead of therapy being a function of the therapist, it is now becoming ever more apparent that the client plays a prime role in the therapeutic process. The qualitative studies presented in this paper provide some examples of research that demonstrates that clients are actively involved in their therapy, even making counselling work despite their counsellor. These studies suggest that clients may not experience therapy as beneficially as traditional outcome studies indicate. This raises a new challenge to researchers to more fully explore the client's experience of therapy, a challenge to which qualitative methods of inquiry would appear well suited

Term admissions to neonatal units in England: a role for transitional care? A retrospective cohort study

Objective To identify the primary reasons for term admissions to neonatal units in England, to determine risk factors for admissions for jaundice and to estimate the proportion who can be cared for in a transitional setting without separation of mother and baby. Design Retrospective observational study using neonatal unit admission data from the National Neonatal Research Database and data of live births in England from the Office for National Statistics. Setting All 163 neonatal units in England 2011–2013. Participants 133 691 term babies born ≥37 weeks gestational age and admitted to neonatal units in England. Primary and secondary outcomes Primary reasons for admission, term babies admitted for the primary reason of jaundice, patient characteristics, postnatal age at admission, total length of stay, phototherapy, intravenous fluids, exchange transfusion and kernicterus. Results Respiratory disease was the most common reason for admission overall, although jaundice was the most common reason for admission from home (22% home vs 5% hospital). Risk factors for admission for jaundice include male, born at 37 weeks gestation, Asian ethnicity and multiple birth. The majority of babies received only a brief period of phototherapy, and only a third received intravenous fluids, suggesting that some may be appropriately managed without separation of mother and baby. Admission from home was significantly later (3.9 days) compared with those admitted from elsewhere in the hospital (1.7 days) (p<0.001). Conclusion Around two-thirds of term admissions for jaundice may be appropriately managed in a transitional care setting, avoiding separation of mother and baby. Babies with risk factors may benefit from a community midwife postnatal visit around the third day of life to enable early referral if necessary. We recommend further work at the national level to examine provision and barriers to transitional care, referral pathways between primary and secondary care, and community postnatal care

The Flag Of My Country

https://digitalcommons.library.umaine.edu/mmb-vp/5396/thumbnail.jp

Term admissions to neonatal units in England: a role for transitional care? A retrospective cohort study

Objective To identify the primary reasons for term admissions to neonatal units in England, to determine risk factors for admissions for jaundice and to estimate the proportion who can be cared for in a transitional setting without separation of mother and baby. Design Retrospective observational study using neonatal unit admission data from the National Neonatal Research Database and data of live births in England from the Office for National Statistics. Setting All 163 neonatal units in England 2011–2013. Participants 133 691 term babies born ≥37 weeks gestational age and admitted to neonatal units in England. Primary and secondary outcomes Primary reasons for admission, term babies admitted for the primary reason of jaundice, patient characteristics, postnatal age at admission, total length of stay, phototherapy, intravenous fluids, exchange transfusion and kernicterus. Results Respiratory disease was the most common reason for admission overall, although jaundice was the most common reason for admission from home (22% home vs 5% hospital). Risk factors for admission for jaundice include male, born at 37 weeks gestation, Asian ethnicity and multiple birth. The majority of babies received only a brief period of phototherapy, and only a third received intravenous fluids, suggesting that some may be appropriately managed without separation of mother and baby. Admission from home was significantly later (3.9 days) compared with those admitted from elsewhere in the hospital (1.7 days) (p<0.001). Conclusion Around two-thirds of term admissions for jaundice may be appropriately managed in a transitional care setting, avoiding separation of mother and baby. Babies with risk factors may benefit from a community midwife postnatal visit around the third day of life to enable early referral if necessary. We recommend further work at the national level to examine provision and barriers to transitional care, referral pathways between primary and secondary care, and community postnatal care

Elementary Derivation of the Chiral Anomaly

An elementary derivation of the chiral gauge anomaly in all even dimensions is given in terms of noncommutative traces of pseudo-differential operators.Comment: Minor errors and misprints corrected, a reference added. AmsTex file, 12 output pages. If you do not have preloaded AmsTex you have to \input amstex.te

Housing system, milk production, and zero-grazing effects on lameness and leg injury in dairy cows

The aim of this study was to assess the effect of grazing (G) vs. zero-grazing (ZG), level of milk production,and quality and type of housing system [free stalls (FS)and straw yards (SY)] on the prevalence of lamenessand leg injuries in dairy cows. Observations were madeon 37 commercial dairy farms across Great Britain. Asingle visit of 5 d duration was made to each farm.During this visit, lameness scores and the incidence ofswellings, rubs, and injuries to hocks and knees wererecorded on all the peak- or mid-lactation cows. Aspectsof the quality of housing and management that werelikely to affect foot and leg health were recorded. Therewere more lame cows on ZG farms (39 ± 0.02%) thanon grazing (G) farms (15 ± 0.01%), and lameness scoreswere higher on FS farms compared with SY farms (0.25± 0.01 vs. 0.05 ± 0.01). Cows on SY farms had fewerhock and knee injuries compared with FS farms. The frequency of knee swellings was higher on ZG farms(0.31 ± 0.02) than on G farms (0.15 ± 0.01). Aspects of the free-stall design affected foot and leg health. The number of hock swellings increased with increasing stall gradient (0.16 ± 0.01 with no slope vs. 0.39 ± 0.02at a 0 to 1.5% slope). There was an interaction between the length of the free-stall lunging space and the hip width of the cow, indicating that the incidence of lameness is generally highest on farms with small free stalls and heavy cows. High levels of milk production did not affect lameness or leg injury. The results indicate that housing cows throughout the year potentially has adetrimental effect on foot and leg health. However, good free-stall design may reduce lameness and leg lesion

Human Cortical Traveling Waves: Dynamical Properties and Correlations with Responses

The spatiotemporal behavior of human EEG oscillations is investigated. Traveling waves in the alpha and theta ranges are found to be common in both prestimulus and poststimulus EEG activity. The dynamical properties of these waves, including their speeds, directions, and durations, are systematically characterized for the first time, and the results show that there are significant changes of prestimulus spontaneous waves in the presence of an external stimulus. Furthermore, the functional relevance of these waves is examined by studying how they are correlated with reaction times on a single trial basis; prestimulus alpha waves traveling in the frontal-to-occipital direction are found to be most correlated to reaction speeds. These findings suggest that propagating waves of brain oscillations might be involved in mediating long-range interactions between widely distributed parts of human cortex

Using Polymeric Ionic Liquids as an Active Binder in Supercapacitors

Electrodes in batteries and supercapacitors generally contain inert binders to maintain their structural integrity during operation but do not participate in the storage of energy. In this paper, we demonstrate that poly ionic liquids can function as structural binders while simultaneously improving the energy storage capability of supercapacitors. Specifically, we show that when the ionic liquid N-butyl-N-methyl pyrrolidinium bis(trifluoromethanesulfonyl)imide is used as electrolyte and poly(diallyldimethylammonium) bis(trifluoromethanesulfonyl)imide is employed as electrode binder the permissible operating voltage of the device is enhanced to 4.0 V. This results in a substantially increased overall specific energy (80% greater) and represents a step toward the development of devices with long cycle lives and high energy densities

New Lower Bounds on the Self-Avoiding-Walk Connective Constant

We give an elementary new method for obtaining rigorous lower bounds on the connective constant for self-avoiding walks on the hypercubic lattice $Z^d$. The method is based on loop erasure and restoration, and does not require exact enumeration data. Our bounds are best for high $d$, and in fact agree with the first four terms of the $1/d$ expansion for the connective constant. The bounds are the best to date for dimensions $d \geq 3$, but do not produce good results in two dimensions. For $d=3,4,5,6$, respectively, our lower bound is within 2.4\%, 0.43\%, 0.12\%, 0.044\% of the value estimated by series extrapolation.Comment: 35 pages, 388480 bytes Postscript, NYU-TH-93/02/0

Association of specific chromosome alterations with tumour phenotype in posterior uveal melanoma

Posterior uveal melanomas have recurrent alterations of chromosomes 1, 3, 6 and 8. In particular, changes of chromosomes 3 and 8 occur in association, appear to characterize those tumours with a ciliary body component, and have been shown to be of prognostic significance. The relevance of other chromosome alterations is less certain. We have performed cytogenetic analysis on 42 previously untreated primary posterior uveal melanomas. Of interest was the observation that as tumour size increased the involvement of specific chromosome changes, and the amount of chromosome abnormalities likewise increased. Loss, or partial deletions, of the short arm of chromosome 1 were found to associate with larger ciliary body melanomas; typically, loss of the short arm resulted from unbalanced translocations, the partners of which varied. Trisomy of chromosome 21 occurred more often in ciliary body melanomas, whilst rearrangements of chromosomes 6 and 11 were primarily related to choroidal melanomas. Our results imply that alterations of chromosome 1 are important in the progression of some uveal melanomas, and that other chromosome abnormalities, besides those of chromosomes 3 and 8, are associated with ocular tumours of particular locations. © 2000 Cancer Research Campaig