Off the Couch and Onto the Streets: Toward an Ethnographic Psychoanalysis

Psychoanalysis has much to gain by incorporating ethnographic methods into its repertoire. Recent works in ethnographic psychoanalysis demonstrate how psychoanalysis stands to function better as both community intervention and participatory action research. This article describes the historical convergence between psychoanalysis and cultural anthropology and situates ethnographic psychoanalysis within interdisciplinary theory and practice

Cultural Adaptation and Reliability Analysis of the Modified Dyspnea Index for the Brazilian Culture

This study aims to present the cross-cultural adaptation process of the Modified Dyspnea Index to the Brazilian culture and to investigate its content validity and reliability. This process included the steps of translation, back translation and review by two experts to assess semantic, conceptual, idiomatic, cultural and metabolic equivalence. The Index of Content Validity was used to evaluate the extent of inter-observer agreement. A Guide to implement the Modified Dyspnea Index was developed and validated. Two different professionals assessed the reliability of the Brazilian version of the Modified Dyspnea Index, according to the inter-observer equivalence criterion, with 31 patients, indicating a Kappa coefficient=0.960 (pEste estudio presenta el proceso de adaptación cultural del Modified Dyspnea Index para la cultura brasileña y la evaluación de su validad de contenido y confiabilidad. Este proceso incluyó las etapas de traducción, retrotraducción y evaluación de la equivalencia semántica, idiomática, conceptual, cultural/experimental y metabólica. El Índice de Validad de Contenido fue utilizado para evaluar la proporción de concordancia entre los jueces. Fue desarrollado y validado un guión para orientar la aplicación del Modified Dyspnea Index. Dos diferentes profesionales evaluaron la confiabilidad de la versión brasileña del Modified Dyspnea Index, de acuerdo con el criterio de la equivalencia inter-observador, en 31 pacientes, apuntando para un coeficiente Kappa=0,960 (pEste estudo apresenta o processo de adaptação cultural do Modified Dyspnea Index para a cultura brasileira e a avaliação de sua validade de conteúdo e confiabilidade. Esse processo incluiu as etapas de tradução, retrotradução e avaliação da equivalência semântica, idiomática, conceitual, cultural/experimental e metabólica. Utilizou-se o Índice de Validade de Conteúdo para avaliar a proporção de concordância entre os juízes. Foi desenvolvido e validado um roteiro para nortear a aplicação do Modified Dyspnea Index. Dois diferentes profissionais avaliaram a confiabilidade da versão brasileira do Modified Dyspnea Index, de acordo com o critério da equivalência interobservador, em 31 pacientes, apontando para um coeficiente Kappa=0,960 (p<0,001). A versão brasileira do Modified Dyspnea Index apresentou provas de equivalência interobservador em amostra de pacientes cardíacos

T2 Values of Posterior Horns of Knee Menisci in Asymptomatic Subjects

[[abstract]]Purpose: The magnetic resonance (MR) T2 value of cartilage is a reliable indicator of tissue properties and therefore may be used as an objective diagnostic tool in early meniscal degeneration. The purpose of this study was to investigate age, gender, location, and zonal differences in MR T2 value of the posterior horns of knee menisci in asymptomatic subjects. Methods: Sixty asymptomatic volunteers (30 men and 30 women) were enrolled and divided into three different age groups: 20–34, 35–49 and 50–70 years. The inclusion criteria were BMI＜30 kg/cm2, normalized Western Ontario and McMaster Universities (WOMAC) pain score of zero, and no evidence of meniscal and ligamentous abnormalities on routine knee MR imaging. The T2 values were measured on images acquired with a T2-weighted fat-suppressed turbo spin-echo sequence at 3T. Results: The mean T2 values in both medial and lateral menisci for the 20–34, 35–49, and 50–70 age groups were 9.94 msec±0.94, 10.73 msec±1.55, and 12.36 msec±2.27, respectively, for women and 9.17 msec±0.74, 9.64 msec±0.67, and 10.95 msec±1.33, respectively, for men. The T2 values were significantly higher in the 50–70 age group than the 20–34 age group (P＜0.001) and in women than in men (P = 0.001, 0.004, and 0.049 for each respective age group). T2 values were significantly higher in medial menisci than in lateral menisci only in women age 50–70 (3.33 msec, P = 0.006) and in the white zone and red/white zone of the 50–70 and 35–49 age groups than that of the 20–34 age group (2.47, 1.02; 2.77, 1.16 msec, respectively, all P＜0.01). Conclusion: The MR T2 values of the posterior meniscal horns increase with increasing age in women and are higher in women than in men. The age-related rise of T2 values appears to be more severe in medial menisci than in lateral menisci. Differences exist in the white zone and red/white zone.[[incitationindex]]SCI[[booktype]]電子

Effect of reducing groundwater on the retardation of redox-sensitive radionuclides

Laboratory batch sorption experiments were used to investigate variations in the retardation behavior of redox-sensitive radionuclides. Water-rock compositions were designed to simulate subsurface conditions at the Nevada Test Site (NTS), where a suite of radionuclides were deposited as a result of underground nuclear testing. Experimental redox conditions were controlled by varying the oxygen content inside an enclosed glove box and by adding reductants into the testing solutions

Integration of modeling and simulation into hospital-based decision support systems guiding pediatric pharmacotherapy

<p>Abstract</p> <p>Background</p> <p>Decision analysis in hospital-based settings is becoming more common place. The application of modeling and simulation approaches has likewise become more prevalent in order to support decision analytics. With respect to clinical decision making at the level of the patient, modeling and simulation approaches have been used to study and forecast treatment options, examine and rate caregiver performance and assign resources (staffing, beds, patient throughput). There us a great need to facilitate pharmacotherapeutic decision making in pediatrics given the often limited data available to guide dosing and manage patient response. We have employed nonlinear mixed effect models and Bayesian forecasting algorithms coupled with data summary and visualization tools to create drug-specific decision support systems that utilize individualized patient data from our electronic medical records systems.</p> <p>Methods</p> <p>Pharmacokinetic and pharmacodynamic nonlinear mixed-effect models of specific drugs are generated based on historical data in relevant pediatric populations or from adults when no pediatric data is available. These models are re-executed with individual patient data allowing for patient-specific guidance via a Bayesian forecasting approach. The models are called and executed in an interactive manner through our web-based dashboard environment which interfaces to the hospital's electronic medical records system.</p> <p>Results</p> <p>The methotrexate dashboard utilizes a two-compartment, population-based, PK mixed-effect model to project patient response to specific dosing events. Projected plasma concentrations are viewable against protocol-specific nomograms to provide dosing guidance for potential rescue therapy with leucovorin. These data are also viewable against common biomarkers used to assess patient safety (e.g., vital signs and plasma creatinine levels). As additional data become available via therapeutic drug monitoring, the model is re-executed and projections are revised.</p> <p>Conclusion</p> <p>The management of pediatric pharmacotherapy can be greatly enhanced via the immediate feedback provided by decision analytics which incorporate the current, best-available knowledge pertaining to dose-exposure and exposure-response relationships, especially for narrow therapeutic agents that are difficult to manage.</p

Risk Factors for Ocular Chlamydia after Three Mass Azithromycin Distributions

Trachoma, which is the leading infectious cause of blindness worldwide, is caused by repeated ocular infection with Chlamydia trachomatis. Treatment for trachoma includes mass azithromycin treatments to the entire community. The World Health Organization recommends at least 3 rounds of annual mass antibiotic distributions in areas with trachoma, with further mass treatments based on the prevalence of trachoma. However, there are other options for communities that have received several rounds of treatment. For example, programs could continue antibiotic treatments only in those households most likely to have infected individuals. In this study, we performed trachoma monitoring on children from 12 Ethiopian communities one year after a third mass azithromycin treatment, and conducted a household survey at the same time. We found that children were more likely to be infected with ocular chlamydia if they had ocular inflammatory signs or ocular discharge, or if they had missed the preceding antibiotic treatment, had an infected sibling, or came from a larger community. These risk factors suggest that after mass azithromycin treatments, trachoma programs could consider continuing antibiotic distributions to households that have missed prior antibiotic distributions, in households with children who have the clinical signs of trachoma, and in larger communities