Intrapartum detection of Group B streptococci colonization by rapid PCR-test on labor ward

OBJECTIVE Group B streptococci (GBS) may lead to early onset neonatal sepsis with severe morbidity and mortality of newborns. Intrapartum detection of GBS is needed. The objective was to compare a PCR-based test performed in the laboratory versus labor ward. STUDY DESIGN 300 patients were included prospectively. In phase I, swabs were analyzed by selective culture and rapid PCR in the laboratory. In phase II, swabs were analyzed accordingly, but the PCR test was conducted in labor ward. Test performances were analyzed and compared. RESULTS In phase I the rapid PCR test had a sensitivity of 85.71% and a specificity of 95.9%. The GBS colonization rate was 18.67%. Overall 8.5% of the PCR results were invalid. In phase II the PCR test showed a sensitivity of 85.71% and a specificity of 95.65%. The GBS colonization rate was 23.3%. Overall 23.5% of swabs tested with PCR were invalid. Initiation of specific, short 2-hour training for operating personnel in the labor ward reduced the invalid test rate to 13.4%. CONCLUSION The rapid PCR-based test yields adequate results to identify GBS colonization when performed in labor ward. In order to reduce the number of invalid tests a short training period is needed.

Moments of tension and strain in psychotherapy and how they promote a good alliance and outcome

It is well established that the therapeutic relationship contributes about as much to therapy outcome as ‘technical’ intervention. Furthermore, it follows clear prescriptive concepts in the same manner as technical interventions do. ‘Motive Oriented Therapeutic Relationship’ is such a concept for establishing a solid basis for whatever therapeutic work the patients’ problems require (Grawe, 1980, 1992; Caspar, 1996). Yet, the therapeutic relationship doesn’t explain everything because other factors play a significant role too. Previous studies showed that outcome is clearly better when therapists achieved a generally high quality of a therapeutic relationship when they did not shy away from possibly threatening interventions such as confrontations. This ratio of a fruitful alliance and marginally present confrontations in the same session also showed significant correlations with patient’s assessment of alliance and progress in therapy (Figlioli et al., 2009). The current state of research in the field, however, does not give any answers to questions like how good and bad confrontations can be characterized or what role does the intensity, respectively frequency of confrontations play in the process of psychotherapy. Therefore, we analyzed a sample of 80 therapies of 3 sessions each representing either good or bad outcome. Independent raters judged moment by moment how therapists used confrontative interventions. 20 cases, which showed an excellent or a very poor outcome, as well as an unexpected pattern were analyzed in further quantitative details. We found that confrontations are correlated to good outcome when they are uttered implicitly, related to an important topic of the patient (e.g. one of the defined therapy goals), long but weak, embedded in prior complementarity and not in the first three sessions of a therapy, as well as not an interactional discrepancy between the patient and the therapist.

Challenges and opportunities related to the creation of a unique society of specialists in general internal medicine in 2015

A common training plan in general internal medicine was a brave enterprise started in 2011 in accordance with the common objectives of the Swiss Society of General Medicine and the Swiss Society of Internal Medicine. The next challenge will be the dissolution of the two Societies and therefore the creation of an unique new association in 2015. This is an extraordinary opportunity to bring together the specific qualities of each association and to create a new society. Issues, objectives and secondary benefits expected from the creation of the largest national society of a medical discipline are explored as a joint discussion in this article.

Occupational mobility chains and the role of job opportunities for upward, lateral and downward mobility in Switzerland

This paper addresses the rarely studied relationship between job vacancies and inter-firm upward, lateral, and downward status mobility in an occupationally segmented labor market, taking Switzerland as the example. To conceptualize mobility mechanisms in this type of labor market, we introduce the concept of “occupational mobility chains” and test its validity. This concept provides the backdrop for developing time-dependent measures of individual job opportunities based on Swiss Job Monitor data. We link these measures with career data taken from the Swiss Life History Study and employ event history analysis to test different propositions of the ways in which status mobility is contingent on the number and the status of vacant positions. Results support our assumption that in occupationally segmented labor markets vacant positions affect status mobility only to the degree that they are located within workers’ occupational mobility chains.

Le personnage de la femme-artiste chez l'écrivain polonaise Narcyza Żmichowska (1819-1876) : Helusia héritière de Corinne de Mme de Staël et de Consuelo de George Sand

Si les hommes bénéficient d’emblée de mythes (Pygmalion, Orphée) qui légitiment et motivent leur créativité, il faut attendre Corinne (1807) de Mme Staël et Consuelo (1842) de George Sand pour que le mythe de la femme créatrice trouve enfin, dans la littérature européenne, à se concrétiser et à se développer sous la forme de Künstlerromane féminins. Corinne la poétesse et Consuelo la cantatrice sont devenues des exemples littéraires non seulement pour les femmes victoriennes, comme le montre par exemple le livre de Linda Lewis intitulé Germaine de Staël, George Sand and the Victorian Woman Artist, mais également pour les femmes polonaises issues des classes favorisées - qui lisaient d’ailleurs couramment en français. En effet, même si elles ont été officiellement décriées par la critique conservatrice polonaise pour leur « immoralité », George Sand et Mme de Staël ont été lues, bien lues et même beaucoup lues par leurs contemporaines polonaises - comme le témoigne la correspondance de ces dernières, dans laquelle elles ont moins de peine à se livrer. Le thème de la femme artiste déchirée entre la carrière publique et la vie privée, tel qu’il est représenté dans Corinne et dans Consuelo, a en particulier attiré toute leur attention et suscité chez les femmes écrivains le désir d’apporter de nouvelles manières de résoudre ce conflit. Dans cet article, le Künstlerinroman polonais Książka Pamiątek (Livre des souvenirs, 1846) de Narcyza Żmichowska fait l’objet d’une analyse comparative détaillée avec les deux Künstlerinromane français dont par ailleurs il se réclame.

Training synaesthesia

Abstract. Synaesthetic inducers such as graphemes are typically cultural artifacts. Thus, a learning component seems evident in synaesthesia (Simner et al, 2009 Brain 132 57 – 64). Normally, synaesthetes report to have their experiences since they can remember. Nevertheless, a recent training study suggests that synaesthesia can be mimicked in non-synaesthetes. To date, the role of learning during the development of synaesthesia is still debated. It is not clear whether synaesthesia can be learned or trained at all. To address this question, we compared a non-adaptive and an adaptive training for their effectiveness. We assessed their impact on two types of priming tasks, before and after the training. We found stronger priming in the adaptive training group suggesting that adaptive training is more efficient to mimic synaesthesia.

Endemic pemphigus foliaceus: towards understanding autoimmune mechanisms of disease development

Fogo selvagem is an endemic form of pemphigus foliaceus (EPF) found in Brazil. Environmental and genetic factors are thought to contribute to the disease, which is associated with pathogenic IgG4 autoantibodies against the desmosomal cadherin desmoglein 1. In this issue, as an additional framework to understand autoimmune mechanisms in EPF, Flores et al. have investigated whether fogo selvagem patients and healthy individuals from endemic areas develop autoantibody responses against other desmosomal cadherins and E-cadherin.