997 resultados para Zimmermann, WilhelmZimmermann, WilhelmWilhelmZimmermann
Resumo:
Following the seminal work on personal identity of Erikson, Marcia's identity status model has been one of the most enduring paradigms. The Ego Identity Process Questionnaire (EIPQ; Balistreri, Busch-Rossnagel, & Geissinger, 1995) is a widely used measure of identity status. The purpose of this study was to evaluate the factor structure and the reliability of a French version of the EIPQ. The hypothesized structures were not confirmed. In light of the failed attempts to validate the original version, an alternative short-form version of the EIPQ (EIPQ-SF), maintaining the integrity of the original model, was developed in one sample and cross-validated in another sample. Additionally, theoretically consistent associations between the EIPQ-SF dimensions and self-esteem confirmed convergent validity. Globally, the results indicated that the French short-version of the EIPQ might be a useful instrument for the assessment of the identity statuses in adolescence and emerging adulthood.
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There are some rationales for developing anticonvulsants for the treatment of substance abuse. The blockade of the AMPA/kainate subtype of glutamate receptor by topiramate may be of particular interest, as preclinical studies of withdrawal from opioids suggest that whilst AMPA-receptor antagonists may not be able to prevent tolerance or dependence from developing, they may ameliorate both physical and emotional consequences of withdrawal. Methods. Ten consecutively admitted patients treated with topiramate were compared in a retrospective naturalistic drug utilization observation study with 10 consecutively admitted patients treated with clonidine and with 10 consecutively admitted patients treated with a carbamazepine/ mianserin combination. Results. In 9 cases of the clonidine group and in 7 carbamazepine/mianserin treated patients the dose had been reduced, whereas this occurred in only 2 topiramate treated patients (p < 0.01). Patients in the topiramate group received less p.r.n. myorelaxant medication than the two other groups, and there was a significant difference between the three groups with regard to p.r.n. analgesics (p < 0.05), topiramate and clonidine treated patients receiving fewer analgesics than the carbamazepine/mianserin group. Conclusions. Compared to clonidine and carbamazepine/mianserin, a detoxification scheme using high initial and then decreasing doses of topiramate appeared to be appropriate for most patients and as associated with less analgesic and myorelaxant comedication, indicating a more promising efficacy at the used doses
Resumo:
The usefulness of species distribution models (SDMs) in predicting impacts of climate change on biodiversity is difficult to assess because changes in species ranges may take decades or centuries to occur. One alternative way to evaluate the predictive ability of SDMs across time is to compare their predictions with data on past species distributions. We use data on plant distributions, fossil pollen and current and mid-Holocene climate to test the ability of SDMs to predict past climate-change impacts. We find that species showing little change in the estimated position of their realized niche, with resulting good model performance, tend to be dominant competitors for light. Different mechanisms appear to be responsible for among-species differences in model performance. Confidence in predictions of the impacts of climate change could be improved by selecting species with characteristics that suggest little change is expected in the relationships between species occurrence and climate patterns.
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Contexte: Le désir de hâter la survenue de leur mort (DM)¦exprimé par certains patients est souvent vécu difficilement¦par les soignants. Le débat actuel sur le¦suicide assisté et l'euthanasie met en lumière cette¦problématique encore peu explorée. Le but de cette¦revue est d'identifier la prévalence du DM et les¦facteurs associés à ce désir.¦Méthode: Une revue de littérature a été conduite jusqu'en¦septembre 2010 en utilisant les termes : « Wish to¦die/to hasten death - Desire to hasten death/for¦death/for early death - Request for assistance in¦dying - Assisted suicide - Euthanasia » et « Advanced/¦terminal illness - Chronic illness/disease ». Seules les¦études cliniques menées auprès de patients ont été¦sélectionnées.¦Résultats: 55 études ont été identifiées, dont 13 de type qualitatif¦: 63% d'entre elles portaient sur des patients¦atteints de cancer, 22% de maladies de diverses origines,¦9% d'VIH et 6% de sclérose latérale amyotrophique.¦Seulement 9% portaient spécifiquement sur¦des patients gériatriques. La définition du DM était¦très variable d'une étude à l'autre, allant du désir de¦mourir à un souhait de hâter la survenue de la mort,¦voire à une demande explicite d'assistance au suicide¦ou d'euthanasie. La prévalence du DM variait¦de 2 à 22% selon la définition utilisée et la population¦étudiée. Les facteurs les plus fréquemment associés¦au DM étaient la dépression, le désespoir, la perte¦de sens, de dignité et le sentiment d'être une charge.¦Les symptômes physiques et les autres dimensions¦psychosociales ne paraissaient jouer qu'un rôle indirect.¦Une instabilité temporelle du DM était rapportée¦par neuf travaux, notamment lors de dépression.¦Discussion: L'hétérogénéité de ces études ne permet pas de¦conclure sur la prévalence des différentes expressions¦du DM. Par ailleurs, même si certains facteurs¦semblent associés au DM, de nouvelles études sont¦nécessaires pour mieux comprendre la chronologie¦de son développement.¦Perspectives: Des études prospectives, utilisant notamment une¦approche mixte, qualitative et quantitative, sont nécessaires. Elles devraient explorer non seulement les facteurs de risque mais également les facteurs « protecteurs » du DM. Sur cette base, un modèle conceptuel pourrait être défini et utilisé ensuite pour développer des interventions spécifiques dans l'objectif d'améliorer la prise en charge des patients exprimant un tel désir.¦Références: 1. Hudson PL, Kristjanson LJ, Ashby M, et al. Desire for hastened death in patients with advanced disease and the evidence base of clinical¦guidelines : a systematic review. Palliat Med 2006;20:693-701.¦2. Schroepfer TA. Mind frames towards dying and factors motivating their adoption by terminally ill elders. J Gerontol 2006;61:S129-S139.¦3. Rodin G, Lo C, Mikulincer M, Donner A, Gagliese L, Zimmermann C.¦Pathways to distress : the multiple determinants of depression, hopelessness, and the desire for hastened death in metastatic cancer¦patients. Soc Sci Med 2009;68:562-9.
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OBJECTIVE: Depersonalization is a fascinating clinical phenomenon referring to a self-consciousness disorder, characterized by emotional detachment from one's own feelings, thoughts, or actions. This article intends to summarize the current literature in this area. METHOD: Using the Medline data base, we reviewed literature addressing the clinical, etiology, nosology, physiopathology, and treatment of depersonalization. CONCLUSIONS: Derealization means that perception of the world and of external reality are altered. These 2 phenomena are often associated. They are not specific to any psychiatric entity and are reported in many different psychiatric syndromes. Many factors, including use of different substances, are involved in their onset. The physiopathology is still little known. However, some conceptual models suggest partial amygdala inhibition combined with activation of other amygdaloid structures. A serotoninergic functioning impairment is indicated in different pharmacologic studies. Different psychotropic drugs, especially serotoninergic antidepressants, have been proposed for pharmacotherapy; however, there are no conclusive randomized studies, and the contribution of psychotherapy in treating these patients is still questioned
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The Mediterranean basin is considered a hotspot of biological diversity with a long history of modification of natural ecosystems by human activities, and is one of the regions that will face extensive changes in climate. For 181 terrestrial mammals (68% of all Mediterranean mammals), we used an ensemble forecasting approach to model the future (approx. 2100) potential distribution under climate change considering five climate change model outputs for two climate scenarios. Overall, a substantial number of Mediterranean mammals will be severely threatened by future climate change, particularly endemic species. Moreover, we found important changes in potential species richness owing to climate change, with some areas (e.g. montane region in central Italy) gaining species, while most of the region will be losing species (mainly Spain and North Africa). Existing protected areas (PAs) will probably be strongly influenced by climate change, with most PAs in Africa, the Middle East and Spain losing a substantial number of species, and those PAs gaining species (e.g. central Italy and southern France) will experience a substantial shift in species composition.
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Background: The divergent glacial histories of southern and northern Europe affect present-day species diversity at coarse-grained scales in these two regions, but do these effects also penetrate to the more fine-grained scales of local communities?Methodology/Principal Findings: We carried out a cross-scale analysis to address this question for vascular plants in two mountain regions, the Alps in southern Europe and the Scandes in northern Europe, using environmentally paired vegetation plots in the two regions (n = 403 in each region) to quantify four diversity components: (i) total number of species occurring in a region (total gamma-diversity), (ii) number of species that could occur in a target plot after environmental filtering (habitat-specific gamma-diversity), (iii) pair-wise species compositional turnover between plots (plot-to-plot beta-diversity) and (iv) number of species present per plot (plot gamma-diversity). We found strong region effects on total gamma-diversity, habitat-specific gamma-diversity and plot-to-plot beta-diversity, with a greater diversity in the Alps even towards distances smaller than 50 m between plots. In contrast, there was a slightly greater plot alpha-diversity in the Scandes, but with a tendency towards contrasting region effects on high and low soil-acidity plots.Conclusions/Significance: We conclude that there are strong regional differences between coarse-grained (landscape- to regional-scale) diversity components of the flora in the Alps and the Scandes mountain ranges,but that these differences do not necessarily penetrate to the finest-grained (plot-scale) diversity component, at least not on acidic soils. Because different processes can lead to a similar pattern, we discuss the consistency of our results with Quaternary history and other divergent features between the two regions such as habitat connectivity, selection for vagility and environmental differences not accounted for in our analyses
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MI-based interventions are widely used with a number of different clinical populations and their efficacy has been well established. However, the clinicians' training has not traditionally been the focus of empirical investigations. We conducted a meta-analytic review of clinicians' MI-training and MI-skills findings. Fifteen studies were included, involving 715 clinicians. Pre-post training effect sizes were calculated (13 studies) as well as group contrast effect sizes (7 studies). Pre-post training comparisons showed medium to large ES of MI training, which are maintained over a short period of time. When compared to a control group, our results also suggested higher MI proficiency in the professionals trained in MI than in nontrained ones (medium ES). However, this estimate of ES may be affected by a publication bias and therefore, should be considered with caution. Methodological limitations and potential sources of heterogeneity of the studies included in this meta-analysis are discussed.