Alkalinity and chemical oxygen demand in some Finnish rivers during the periods 1911—1931 and 1962—1979

Eräiden Suomen jokien alkaliniteetti- ja CODMn-arvoja vuosilta 1911—1931 ja 1962—197

The role of pre-treatment interpersonal problems for in-session emotional processing and long-term outcome in emotion-focused psychotherapy

Objective: Interpersonal problems may lead to, uphold, or follow from depression. However, we know little of how depressed patients' different interpersonal problems are associated with patients' emotional processing during psychotherapy and whether distinct processes are helpful for their long-term reduction. Method: 23 adult outpatients who received emotion-focused therapies lasting 16-20 sessions filled the Inventory of Interpersonal Problems at pre- and post-treatment and 18-month follow-up. These problems were related to emotional processing in two mid-therapy sessions, rated by observers with the Classification of Affective-Meaning States. Results: All pre-treatment interpersonal problems were clearly associated with patients' negative evaluations of themselves during therapy. Self-experiences of vindictiveness were most pronouncedly linked to in-session emotional expressions of rejecting anger, and self-experiences of social inhibition to expressions of fear and shame, following a circumplex model. In the long-term reduction of interpersonal problems, especially reaching emotional states of hurt and grief seemed beneficial for patients who experienced themselves as socially inhibited, non-assertive, self-sacrificing, or overly accommodating. Conclusions: For clients suffering from particular interpersonal problems, accessing particularly beneficial emotional processes, such as hurt and grief, may form specific therapeutic process goals. Further studies should verify these findings, which link interpersonal theory with research on emotional processing in psychotherapy.Peer reviewe

What Works for Whom : Patients' Psychological Resources and Vulnerabilities as Common and Specific Predictors of Working Alliance in Different Psychotherapies

Publisher Copyright: Copyright © 2022 Heinonen, Knekt and Lindfors.Background: Across different types of psychotherapy, one of the most robust predictors of better therapeutic outcomes is a good working alliance between patient and therapist. Yet there is little comparative research on whether particular patients more likely achieve a better alliance in certain treatments which represent particular therapeutic approaches or durations. Methods: 326 patients suffering from depressive and/or anxiety disorder were randomized into two short-term (solution-focused or psychodynamic) and one long-term (psychodynamic) therapy models. Treatments lasted ~7 and 36 months, respectively. Before randomization, patients were assessed with the interview-based Suitability for Psychotherapy Scale and filled Childhood Family Atmosphere and Life Orientation Test questionnaires. Patients filled Working Alliance Inventory after 3rd therapy session and at end of treatment; the long-term therapy patients, additionally, at 7 months' time point. Linear regression models were used. Results: Greater psychological resources (e.g., capacity for self-reflection, affect regulation, flexible interaction) had little effect on alliance during the course of the short-term therapies. However, they did predict better working alliances at end of long-term as opposed to short-term therapy. Childhood adversities impacted alliances already at 7 months. Conclusions: Although patients with certain qualities achieve better alliances in long-term as opposed to short-term therapies, apparently the theoretical orientation of therapy makes little difference. For patients with childhood adversities, differences between long-term (psychodynamic) treatment vs. various brief therapy models may be particularly salient.Peer reviewe

The professional and personal characteristics of effective psychotherapists : a systematic review

Objective: Psychotherapists differ notably in the outcomes their patients achieve, and the characteristics that may explain these differences have attracted increasing interest. We systematically review studies on therapist pre-treatment characteristics predicting patient outcomes. Method: Systematic searches on databases for psychotherapy research, clinical psychology, and medical science for the years 2000-2018 identified published research examining therapist characteristics and psychotherapy outcomes. Of 2041 studies, 31 met inclusion criteria. Results: Findings show a few direct effects of therapist intrapersonal variables (e.g., self-relatedness, attachment) and several interaction effects with other constructs (e.g., patient pathology) on outcome. There is little support for the relevance of self-rated social skills. However, more consistent evidence has recently emerged for performance-based measurements of professional interpersonal skills, especially when elicited in challenging situations. Patient outcomes were also predicted by therapists' self-rated professional characteristics, such as their experienced difficulties in practice, coping mechanisms, and attitudes towards therapeutic work, indicating that therapist self-perception also matters, although not always in the direction expected. Conclusions: More effective therapists seem characterized by professionally cultivated interpersonal capacities, which are likely rooted in their personal lives and attachment history. Research guidelines are proposed for moving this field forward (including larger samples, multilevel modeling, and in-depth qualitative work).Peer reviewe

Associations of early childhood adversities with mental disorders, psychological functioning, and suitability for psychotherapy in adulthood

Childhood adversities frequently precede adulthood depression and anxiety. Yet, how they impact needed treatment duration, type or focus in these common disorders, is unclear. For developing more individualized and precise interventions, we investigated whether specific early adversities associate with patients' distinct psychiatric problems, psychological vulnerabilities, and suitability for psychotherapy. A total of 221 depressed and anxious adult outpatients (excluding psychotic, severe personality, bipolar, and substance abuse disorders) referred from community, student, occupational, and private healthcare services filled the Childhood Family Atmosphere Questionnaire (CFAQ). They also filled self-reports on interpersonal behavior and problems, perceived competence, dispositional optimism, sense of coherence, defenses, and psychiatric history. Clinicians assessed the patients' symptomatology, personality, object relations, cognitive performance, and psychotherapy suitability. Regression analyses were conducted. Childhood adversities predicted both worse current psychological functioning (e.g., interpersonal problems), and better clinician-rated capacities for benefiting from psychotherapy (e.g. self-reflection, capacity for interaction). Parental problems had the most numerous negative associations to psychological functioning. Best capacities for psychotherapy were predicted by recollected family unhappiness. Associations with psychiatric criteria were, however, largely non-significant. In conclusion, for psychosocial treatment planning, patients' early adversities may indicate both vulnerability and resources. As childhood adversities are frequent among treatment-seekers, further studies examining how early adversities predict psychotherapy outcome are needed.Peer reviewe

Sopiiko potilaalleni psykoterapia?

Vain va­jaa kol­mannes suoma­lai­sista psy­ko­te­ra­peu­teista ar­vioi asiak­kai­densa saa­neen riit­tävää oh­jausta psy­ko­te­rapiaan. Psy­ko­te­rapiaa edel­tävä ar­viointi ja oh­jaus edis­tävät hoi­toon sitou­tu­mista ja te­rapian tulok­sel­li­suutta. Po­tilaan muutos­valmius, ky­ky tarkas­tella it­seä ja omia tun­teita se­kä jous­tavuus vuoro­vai­ku­tuk­sessa ­ennus­tavat toden­nä­köi­sempää ky­kyä tera­peut­tiseen työsken­telyyn ja lyhyes­täkin psy­ko­te­ra­piasta ­hyö­ty­miseen. Po­tilaan ja psy­ko­te­ra­peutin hy­vä yhteis­työ­suhde en­nustaa hoito­tu­losta merkit­tä­västi. Poti­lasta on syy­tä val­mentaa ar­vioimaan, minkä­laisen psy­ko­te­ra­peutin kans­sa hän ko­kee voi­vansa muo­dostaa hy­vän yhteis­työ­suhteen. Po­tilaan val­miuksien ja psy­ko­te­rapian tavoit­teiden ol­lessa epä­selviä on syy­tä konsul­toida psy­kiat­rista ­eri­kois­sai­raan­hoitoa.Peer reviewe

Evaluating a novel formula for noninvasive estimation of arterial carbon dioxide during post-resuscitation care

Background Controlling arterial carbon dioxide is paramount in mechanically ventilated patients, and an accurate and continuous noninvasive monitoring method would optimize management in dynamic situations. In this study, we validated and further refined formulas for estimating partial pressure of carbon dioxide with respiratory gas and pulse oximetry data in mechanically ventilated cardiac arrest patients. Methods A total of 4741 data sets were collected retrospectively from 233 resuscitated patients undergoing therapeutic hypothermia. The original formula used to analyze the data is PaCO2-est1 = PETCO2 + k[(PIO2 - PETCO2) - PaO2]. To achieve better accuracy, we further modified the formula to PaCO2-est2 = k(1)*PETCO2 + k(2)*(PIO2 - PETCO2) + k(3)*(100-SpO(2)). The coefficients were determined by identifying the minimal difference between the measured and calculated arterial carbon dioxide values in a development set. The accuracy of these two methods was compared with the estimation of the partial pressure of carbon dioxide using end-tidal carbon dioxide. Results With PaCO2-est1, the mean difference between the partial pressure of carbon dioxide, and the estimated carbon dioxide was 0.08 kPa (SE +/- 0.003); with PaCO2-est2 the difference was 0.036 kPa (SE +/- 0.009). The mean difference between the partial pressure of carbon dioxide and end-tidal carbon dioxide was 0.72 kPa (SE +/- 0.01). In a mixed linear model, there was a significant difference between the estimation using end-tidal carbon dioxide and PaCO2-est1 (P <.001) and PaCO2-est2 (P <.001) respectively. Conclusions This novel formula appears to provide an accurate, continuous, and noninvasive estimation of arterial carbon dioxide.Peer reviewe

Designing and Implementing Common Market for Cross-Game Purchases between Mobile Games

The mobile game markets are increasingly competitive and the game publishers are looking for new ways to increase player retention and cross commercialization of games. In this paper, we examine how a purchasing system using virtual currency based common market can be designed and implemented in order to create a larger service platform. The solution enables cross-game purchasing of virtual items from one game into another. We present how such a system can be designed, how it would fit into larger vision of multi-game ecosystem and what kind of limitations there are when implementing such a system. As a result, we describe solution of a bank and a marketplace entity, which are responsible of the transactions, virtual items and connecting games to each other. As a conclusion, we are presenting the expected challenges and expansion plans for the common market system

Estimation of Arterial Carbon Dioxide Based on End-Tidal Gas Pressure and Oxygen Saturation

Arterial blood gas (ABG) analysis is the traditional method for measuring the partial pressure of carbon dioxide. In mechanically ventilated patients a continuous noninvasive monitoring of carbon dioxide would obviously be attractive. In the current study, we present a novel formula for noninvasive estimation of arterial carbon dioxide. Eighty-one datasets were collected from 19 anesthetized and mechanically ventilated pigs. Eleven animals were mechanically ventilated without interventions. In the remaining eight pigs the partial pressure of carbon dioxide was manipulated. The new formula (Formula 1) is PaCO2 = PETCO2 + k(PETO2 - PaO2) where PaO2 was calculated from the oxygen saturation. We tested the agreements of this novel formula and compared it to a traditional method using the baseline PaCO2 - ETCO2 gap added to subsequently measured, end-tidal carbon dioxide levels (Formula 2). The mean difference between PaCO2 and calculated carbon dioxide (Formula 1) was 0.16 kPa (+/- SE 1.17). The mean difference between PaCO2 and carbon dioxide with Formula 2 was 0.66 kPa (+/- SE 0.18). With a mixed linear model excluding cases with cardiorespiratory collapse, there was a significant difference between formulae (p <0.001), as well as significant interaction between formulae and time (p <0.001). In this preliminary animal study, this novel formula appears to have a reasonable agreement with PaCO2 values measured with ABG analysis, but needs further validation in human patients.Peer reviewe