Understanding Countertransference with Patients with Borderline Personality Disorder : an Exploratory Quantitative Investigation

The present study surveyed 58 psychologists regarding their countertransference (CT) behaviors, CT management ability, empathy, and working alliances when treating patients with borderline personality disorder (BPD). Common positive and negative CT behaviors were identified when treating their typical patient with BPD. As predicted, results yielded negative correlations between therapists\u27 CT behaviors and their CT management ability, working alliance, and empathy, as well as a positive correlation between therapists\u27 CT management and working alliance, linking CT management to positive treatment outcomes. Therapists\u27 level of experience and theoretical orientation were also examined, finding no significant impact on CT behaviors, CT management, or working alliance. Implications for training and supervision of therapists treating patients with BPD, suggestions for future research, and limitations of the study are discussed

Park Visitors and the Natural Soundscape: Winter Experience Dimensions in Yellowstone National Park

The natural soundscape is becoming increasingly recognized as a threatened park resource. A variety of policies, laws, and regulations have rapidly been established that affect the National Park Service mandate and require the agency and individual parks to protect, preserve, and restore natural sounds. National Parks are grappling with how to manage the newly legitimized natural soundscape resource and this research provides some of the first significant knowledge of visitor experiences of park soundscapes and preferences for management policies. The role of the natural soundscape in visitor experiences was explored through both interview and survey data with the primary goal of documenting dimensions of the experiences of natural sounds. Findings from this research highlight that not only do the majority of winter visitors to Yellowstone National Park believe that natural sounds are important to their experience of the park, but that deep meanings and complexity characterize visitor perceptions of the role of the natural soundscape to the overall value of the park and influence perceptions of the role of mechanized sounds in the park. While differences among the three primary user groups (cross-country skiers, snow coach riders, and snowmobilers) do exist, the data reflects a much greater degree of common ground and general agreement on most issues related to the park natural soundscape that were explored in this research

Demand driven approach for sustainability

Demand driven approach for sustainabilit

Comparison of Anesthesia for Dental/Oral Surgery by Office-based Dentist Anesthesiologists versus Operating Room-based Physician Anesthesiologists

Few studies have examined the practice characteristics of dentist anesthesiologists and compared them to other anesthesia providers. Using outcomes from the National Anesthesia Clinical Outcomes Registry and the Society for Ambulatory Anesthesia Clinical Outcomes Registry for dental/oral surgery procedures, we compared 7133 predominantly office-based anesthetics by dentist anesthesiologists to 106,420 predominantly operating room anesthetics performed by physician anesthesia providers. These encounters were contrasted with 34,191 previously published encounters from the practices of oral and maxillofacial surgeons. Children younger than 6 years received the greatest proportion of general anesthetic services rendered by both dentist anesthesiologists and hospital-based anesthesia providers. These general anesthesia services were primarily provided for complete dental rehabilitation for early childhood caries. Overall treatment time for complete dental rehabilitation in the office-based setting by dentist anesthesiologists was significantly shorter than comparable care provided in the hospital operating room and surgery centers. The anesthesia care provided by dentist anesthesiologists was found to be separate and distinct from anesthesia care provided by oral and maxillofacial surgeons, which was primarily administered to adults for very brief surgical procedures. Cases performed by dentist anesthesiologists and hospital-based anesthesia providers were for much younger patients and of significantly longer duration when compared with anesthesia administered by oral and maxillofacial surgeons. Despite the limited descriptive power of the current registries, office-based anesthesia rendered by dentist anesthesiologists is clearly a unique and efficient mode of anesthesia care for dentistry

Differential Expression Of Gap Junction mRNAs And Proteins In The Developing Murine Kidney And In Experimentally Induced Nephric Mesenchymes

The expression of three gap junction (GJ) proteins, alpha-1 (Cx43), beta-1 (Cx32), and beta-2 (Cx26), and their transcripts were examined during the ontogeny of the mouse and rat kidney. These proteins were expressed in two non-overlapping patterns. The alpha-1 GJ protein was first observed in mesenchymal cells in the 12-day mouse kidney. By day 14 and thereafter, the ai protein was detected in the transient S-shaped bodies, but not in the podocytes of the maturing glomeruli. After birth the antigen was retained in a small subset of secretory tubules.The beta-1 and beta-2 GJ proteins were similar in their developmental patterns. They were first detected in a small subset of secretory tubules in the subcortical zone of day 17 embryos. These tubules were identified by immunohistochemical markers to be proximal. At birth, practically all proximal tubules expressed the two antigens.This analysis of GJ proteins was consistent with the results of S1 nuclease protection assays showing that, while the alpha-1 mRNA appeared early during kidney development and declined around birth, the two beta mRNAs appeared later and became intensified during the last days of intrauterine development.In experimentally induced metanephric mesenchymes, a transient expression of the alpha-1 GJ protein was seen during the segregation of the tubular anlagen. beta-1 and beta-2 GJ proteins were not detected in such induced mesenchymes cultivated up to 7 days.These observations provide evidence for the cell-specific utilization of different GJ genes during different stages of kidney organogenesis. The alpha-1 gene is activated during the early segregation of the secretory tubule and might contribute to its compartmentalization, while the beta-1 and beta-2 gene products are not detected until advanced stages of development. The latter gene products might be correlated with the physiological activity of the proximal tubules in vivo, as they are not expressed in experimentally induced tubules detectable with markers for proximal tubules

A Discussion on Uncertainty Representation and Interpretation in Model-Based Prognostics Algorithms based on Kalman Filter Estimation Applied to Prognostics of Electronics Components

This article discusses several aspects of uncertainty representation and management for model-based prognostics methodologies based on our experience with Kalman Filters when applied to prognostics for electronics components. In particular, it explores the implications of modeling remaining useful life prediction as a stochastic process and how it relates to uncertainty representation, management, and the role of prognostics in decision-making. A distinction between the interpretations of estimated remaining useful life probability density function and the true remaining useful life probability density function is explained and a cautionary argument is provided against mixing interpretations for the two while considering prognostics in making critical decisions

Outcome of children with ESBL-E. coli acute pyelonephritis treated with cephalosporins

Non peer reviewe

A Statistical Model for Ascertaining the Influence and Reliability of Weather Parameters on Incidence of Blossom Blight in Mango (Mangifera indica L.)

A statistical model was developed to study the influence and reliability of weatlier parameters on incidence of blossom blight in Mango (Mangifera indica) and subsequently to predict their incidence. Results showed that preceding week's weather variables viz., maximum and minimum temperature, evaporation, rainfall, morning and evening relative humidity and wind speed were found to collectively predict blossom blight incidence to the extent of 94.3 per cent. Further, as a measure of goodness-of-fit, the coefficient of determination (R2) and mean squared error were used to evaluate the empirical model developed by using above variables. Validation test showed that the model developed using relative humidity at 07.30 h (X3), evaporation (X5) and wind speed (X6) (Y = 883.4 - 8.065 X3-11.506 X5 -33.619 X6) could predict the incidence to the extent of 75.7%. This model is useful in determining the role of climatic factors in disease appearance and progression and devising suitable management strategy

Effective peacebuilding in a post-conflict environment : problems and solutions with non-state armed groups

This paper studies post-conflict peacebuilding in relation to non-state armed groups, notably insurgencies. Peacebuilding in general refers to long-term policies that have as their end-goal a just and self-sustaining peace. The view taken of peacebuilding here is state-centered: strengthening a legitimate and accountable state is the best way to protect individuals. The focus is on outside intervention. Also, security is a key concept. The framework advances by 1.) analysing the nature of the problem and the main security threats to peace posed by non-state armed groups, and 2.) examines the current policy-options to these problems, and sees what is effective and what is problematic. The assumption is that there is a common model of peacebuilding, that is not necessarily effective. This is referred to as 'rule-of-thumb peacebuilding. This paper uses literature review as its methods. A number of different types of sources were chosen: theoretical literature on conflicts and peacebuilding including statistical and qualitative research, articles by authoritative experts on each subject, policy handbooks by experts, lessons learned reports, as well as commissioned evaluations. Non-state armed groups are analyzed through their means (capacity) and end-goals. Gangs, organized crime, paramilitary groups, private military companies and insurgencies are examined. While all of these contest the monopoly of violence of the state, only insurgencies pose an existential threat both with respect to its means and end-goals. Yet one of the central findings is that non-state armed groups today have converging interests, and thanks to globalization new weaker but more resilient forms of insurgency emerge relatively easily. These groups can have an interest in the continuation of conflict. Of the different policy-option, I analyze DDR, conflict resolution methods, monitoring, arms control measures, sanctions, counterinsurgency and the pros and cons of interventions in general. Generally, policies could be differentiated between ones that focused on the existing armed group, and ones that focus on changing the environment that enabled them to come about. Key problems found with the commonly applied methods of peacebuilding, or 'rule-of-thumb' peacebuilding, were related to power-sharing arrangements and elections, as well as the attention given to short-term results. Additionally, a longer presence of outside monitoring of the peace process would seem to enhance the sustainability of post-conflict peace. Finally, interventions themselves can also be problematic: they can spread corruption and weaken the connection between the government and the people.Tässä tutkimuksessa tarkastellaan ei-valtiollisia aseistautuneita ryhmiä ja rauhanrakentamista konfliktinjälkeisessä tilanteessa. Rauhanrakentamisella viitataan kaikkeen pitkäkestoiseen toimintaan, jonka ensisijaisena tavoitteena on kestävä ja oikeudenmukainen rauha. Rauhanrakentamista tarkastellaan tässä tutkimuksessa valtiokeskeisesti: oikeudenmukainen valtio, joka on vastuussa kansalaisilleen, takaa parhaiten yksilöiden turvallisuuden. Pääpaino on ulkopuolisten väliintuloissa. Turvallisuus toimii jäsentävänä käsitteenä. Tutkimusasetelma on kaksiosainen: ensiksi pyritään ymmärtämään ongelman luonne ja löytämään keskeiset turvallisuusongelmat ja toiseksi tarkastelemaan käytettyjä toimintamalleja sekä katsomaan mikä on koettu toimivaksi ja mitkä ovat olleet keskeiset ongelmat. Oletuksena on, että on olemassa yleinen rauhanrakentamisen malli, jota käytetään, mutta joka ei välttämättä aina tuota haluttuja tuloksia. Metodologiana toimii kirjallisuuskatsaus. Aineisto koostuu sekä kvantitatiivisista että kvalitatiivisista teoreettisista töistä konflikteista ja rauhanrakentamisesta, eri aiheiden asiantuntijoiden kirjoituksista, kenttäasiantuntijoiden laatimista ohjekirjoista, 'lessons learned' -julkaisuista sekä eri ohjelmien ulkoisista arvioinneista

Työhyvinvointi, koulutus ja toiminnan kehittäminen terveyskeskuksissa lääkäritilanteen näkökulmasta

Finnish health centres have suffered from a shortage of physicians in recent years. This is why more physicians are being educated, the tutelage of the young physicians has been improved and many tasks which were previously reserved for physicians have been transferred to nurses and other personnel of the health centres. Only a little research has been done about the effects of the shortage of physicians and education to the work atmosphere in the health centres The objectives of the study was to describe the situation of the physicians in the counties Satakunta and South-Western Finland at the time when the University of Turku started to decentralise its education to Satakunta and describe the health centres attitudes towards training and research co-operation with the University of Turku; to gain information about the training programmes for physicians in specific training in general medical practice (STPG); study how the shortage of physicians affects the job atmosphere, the job satisfaction and the operation of the health centres; study health centre employees opinions about their professional skills, their needs and interets in continuing education; study medical and nurse students professional indentity and their readiness to multiprofessional teamwork. The material of the study was gathered during 2003-2006 with three mail questionnaires and a questionnaire given to medical and nurse students who practised in the training health centre in Pori. The first questionnaire was sent to the chief physicians of the health centres in counties Satakunta and South-Western Finland to clarify the number of unfilled positions of physicians and the reasons for physician shortage as well as the readiness for practical training of medical students and research at the health centres. The second questionnaire was posted to doctors in specific training in general medical practice and their trainers at the health centres and it gained information about training programmes of young physicians at health centres. The third questionnaire was sent to personnel at health centres in Satakunta and South-Western Finland and included questions about job satisfaction and education. The survey for medical and nurse students gained information about their professional indentity and their readiness to multiprofessional teamwork. In spring 2003 the shortage of physicians was more severe in Satakunta than in South-Western Finland. Attitudes towards training of medical students and research co-operation with the universities were generally positive. The guidance of STGP doctors in health centres improved during 2003-2005. A shortage of physicians had only a slightly negative impact on employee job satisfaction. The shortage of physicians had also positive impact on the operation of the health centres because it led to reorganization of the operations. The personnel at Finnish health centres were willing to take more challenging tasks and also to acquire appropriate further education or training. The medical and nurse students had strong professional identity and they understood the significance of teamwork for the health care service system.Suomen terveyskeskusten toimintaa on vuosia vaikeuttanut lääkärivaje, jota on pyritty helpottamaan muun muassa lääkärikoulutusmääriä lisäämällä, panostamalla nuorten lääkärien ohjaukseen sekä jakamalla uudelleen työtehtäviä terveyskeskusten työntekijäryhmien välillä. Lääkäripulan ja koulutuksen vaikutuksista terveydenhuollon työilmapiiriin on vain vähän tutkimustuloksia. Tutkimuksen tavoitteet ovat: kartoittaa Satakunnan ja Varsinais-Suomen terveyskeskusten lääkäritilanne Turun yliopiston lääketieteen opetuksen laajentuessa Satakuntaan sekä kuvata terveyskeskusten kiinnostusta koulutus- ja tutkimusyhteistyöhön Turun yliopiston kanssa; selvittää perusterveydenhuollon lisäkoulutusvaiheen lääkäreiden ohjauksen toteutumista Satakunnan ja Varsinais-Suomen maakunnissa; tutkia lääkärivajeen merkitystä terveyskeskusten työilmapiirille ja henkilökunnan työhyvinvoinnille sekä terveyskeskusten toiminnalle; tutkia terveyskeskusten henkilökunnan käsitystä ammatillisesta osaamisestaan ja koulutustarpeistaan sekä kouluttautumiskiinnostusta; selvittää lääketieteen ja hoitotyön opiskelijoiden ammatti-identiteettiä sekä heidän valmiuksiaan moniammatilliseen yhteistyöhön. Tutkimuksen aineisto kerättiin vuosina 2003-2006 kolmella erillisellä postikyselyllä sekä Porin opetusterveyskeskuksessa käytännön jaksoilla olleille lääketieteen ja hoitotyön opiskelijoille tehdyillä kyselyllä. Ensimmäinen kysely suunnattiin Satakunnan ja Varsinais-Suomen terveyskeskusten johtaville lääkäreille, ja se kartoitti alueen lääkäritilannetta sekä terveyskeskusten valmiutta koulutus- ja tutkimusyhteistyöhön Turun yliopiston kanssa. Toisessa kyselyssä selvitettiin perusterveydenhuollon lisäkoulutusvaiheen (PTL) lääkärien ohjausjärjestelyjä ja kiinnostusta yleislääketieteeseen Satakunnan ja Varsinais-Suomen terveyskeskuksissa. Kolmannen kyselyn kohderyhmänä oli Satakunnan ja Varsinais-Suomen terveyskeskusten henkilöstö, ja sillä selvitettiin henkilökunnan työtyytyväisyyttä sekä koulutukseen liittyviä tekijöitä. Käytännön opintojaksolla olleille lääketieteen ja hoitotyön opiskelijoille tehdyllä kyselyllä selvitettiin opiskelijoiden ammatti-identiteettiä ja asenteita moniammatilliseen työskentelyyn. Keväällä 2003 Satakunnan terveyskeskusten lääkäritilanne oli selvästi huonompi kuin Varsinais-Suomen. Suurimmassa osassa terveyskeskuksista oli kiinnostusta koulutus- ja tutkimus-yhteistyöhön yliopiston kanssa. Perusterveydenhuollon lisäkoulutusvaiheen lääkäreiden ohjaus Satakunnan ja Varsinais-Suomen terveyskeskuksissa koheni vuosina 2003-2005. Lääkäripulalla oli vain vähän vaikutusta työntekijöiden työviihtyvyyteen. Lääkärivajeella oli myös myönteisiä vaikutuksia terveyskeskusten toiminnalle, koska sen myötä toimintoja järjestetään uudelleen ja tehtäviä priorisoidaan. Pääosa terveyskeskusten henkilöstöstä koki koulutuksensa riittävän nykyiseen tehtäväänsä. Henkilöstöllä oli kiinnostusta laajentaa ja syventää tehtäväkuvaansa sekä myös kouluttautua sitä varten. Lääketieteen- ja hoitotyön opiskelijat omaavat jo opiskeluaikana vahvan ammatti-identiteetin, ja he ymmärtävät oman merkityksensä tiimiytyneessä terveydenhuollon palvelujärjestelmässä.Siirretty Doriast