Emotional processing in a ten-session general psychiatric treatment for borderline personality disorder: a case study.

This study examines the effects of a borderline-specific treatment, called general psychiatric management, on emotional change, outcome and therapeutic alliance of an outpatient presenting with borderline personality disorder. Based on the sequential model of emotional processing, emotional states were assessed in a 10-session setting. The case showed an increase in expressions of distress and no change in therapeutic alliance and tended towards general deterioration. Results suggest emotional processing may play a lesser role in general psychiatric management in early phase treatment than previously hypothezised. Copyright © 2015 John Wiley & Sons, Ltd.

Increased risk of cardiovascular disease (CVD) with age in HIV-positive men : a comparison of the D:A:D CVD risk equation and general population CVD risk equations

OBJECTIVES: The aim of the study was to statistically model the relative increased risk of cardiovascular disease (CVD) per year older in Data collection on Adverse events of anti-HIV Drugs (D:A:D) and to compare this with the relative increased risk of CVD per year older in general population risk equations. METHODS: We analysed three endpoints: myocardial infarction (MI), coronary heart disease (CHD: MI or invasive coronary procedure) and CVD (CHD or stroke). We fitted a number of parametric age effects, adjusting for known risk factors and antiretroviral therapy (ART) use. The best-fitting age effect was determined using the Akaike information criterion. We compared the ageing effect from D:A:D with that from the general population risk equations: the Framingham Heart Study, CUORE and ASSIGN risk scores. RESULTS: A total of 24 323 men were included in analyses. Crude MI, CHD and CVD event rates per 1000 person-years increased from 2.29, 3.11 and 3.65 in those aged 40-45 years to 6.53, 11.91 and 15.89 in those aged 60-65 years, respectively. The best-fitting models included inverse age for MI and age + age(2) for CHD and CVD. In D:A:D there was a slowly accelerating increased risk of CHD and CVD per year older, which appeared to be only modest yet was consistently raised compared with the risk in the general population. The relative risk of MI with age was not different between D:A:D and the general population. CONCLUSIONS: We found only limited evidence of accelerating increased risk of CVD with age in D:A:D compared with the general population. The absolute risk of CVD associated with HIV infection remains uncertain.

Patterns of text layout in Pompeian verse inscriptions

This article explores patterns of formal text layout of the metrical graffiti of Pompeii. After a brief discussion of the importance of formal text layout for linguistic research in general (and its relevance for poetic texts), a representative sample of poetic graffiti is discussed and analysed in detail. It is argued, then, that nature of the surface and sentence structure in particular can take precedence over the ‘default solution’ (coincidence of verse and line structures).

The prevalence and nature of prescribing and monitoring errors in English general practice – a retrospective case note review

Objective To determine the prevalence and nature of prescribing and monitoring errors in general practices in England. Design Retrospective case note review of unique medication items prescribed over a 12 month period to a 2% random sample of patients. Mixed effects logistic regression was used to analyse the data. Setting Fifteen general practices across three primary care trusts in England. Data sources Examination of 6048 unique prescription items prescribed over the previous 12 months for 1777 patients. Main outcome measures Prevalence of prescribing and monitoring errors, and severity of errors, using validated definitions. Results Prescribing and/or monitoring errors were detected in 4.9% (296/6048) of all prescription items (95% confidence interval 4.4 - 5.5%). The vast majority of errors were of mild to moderate severity, with 0.2% (11/6048) of items having a severe error. After adjusting for covariates, patient-related factors associated with an increased risk of prescribing and/or monitoring errors were: age less than 15 (Odds Ratio (OR) 1.87, 1.19 to 2.94, p=0.006) or greater than 64 years (OR 1.68, 1.04 to 2.73, p=0.035), and higher numbers of unique medication items prescribed (OR 1.16, 1.12 to 1.19, p<0.001). Conclusion Prescribing and monitoring errors are common in English general practice, although severe errors are unusual. Many factors increase the risk of error. Having identified the most common and important errors, and the factors associated with these, strategies to prevent future errors should be developed based on the study findings.

The causes of prescribing errors in English general practices: a qualitative study

Aim: To examine the causes of prescribing and monitoring errors in English general practices and provide recommendations for how they may be overcome. Design: Qualitative interview and focus group study with purposive sampling and thematic analysis informed by Reason’s accident causation model. Participants: General practice staff participated in a combination of semi-structured interviews (n=34) and six focus groups (n=46). Setting: Fifteen general practices across three primary care trusts in England. Results: We identified seven categories of high-level error-producing conditions: the prescriber, the patient, the team, the task, the working environment, the computer system, and the primary-secondary care interface. Each of these was further broken down to reveal various error-producing conditions. The prescriber’s therapeutic training, drug knowledge and experience, knowledge of the patient, perception of risk, and their physical and emotional health, were all identified as possible causes. The patient’s characteristics and the complexity of the individual clinical case were also found to have contributed to prescribing errors. The importance of feeling comfortable within the practice team was highlighted, as well as the safety of general practitioners (GPs) in signing prescriptions generated by nurses when they had not seen the patient for themselves. The working environment with its high workload, time pressures, and interruptions, and computer related issues associated with mis-selecting drugs from electronic pick-lists and overriding alerts, were all highlighted as possible causes of prescribing errors and often interconnected. Conclusion: This study has highlighted the complex underlying causes of prescribing and monitoring errors in general practices, several of which are amenable to intervention.

Reverse knowledge transfer: evidence from General Motors in the UK and Poland

This paper explores the concept of a reverse diffusion of knowledge, that is, the transfer flowing from a company’s subsidiary to its home plant. The article presents the empirical evidence gathered in General Motors UK and Poland, where the reverse diffusion of a concept of the built-in quality took place. Lastly, the implications of our findings for future research are discussed.

Internationalizing the MFA in Creative Writing

is article explores the prospects for internationalizing the Master of Fine Arts (MFA) in Creative Writing, a degree that has gained considerable popularity in the United States in the past half century but has yet to gain much of a foothold in other countries. As part of this exploration, we describe the experiences of estab- lishing the first low-residency Master of Fine Arts in Creative Writing in Asia at City University of Hong Kong, explaining the justification for setting up such a program with reference to the history of teaching creative writing and the current conditions for literary writing in English in Asia and globally. We also reflect upon the processes of planning, curriculum design, and administrative negotiation and that went into setting up the program and report on feedback from the first cohort of students. e experience of setting up this program is used as the basis for raising a number of more general issues regarding the teaching of creative writing in English in interna- tional contexts.

Student and Faculty Perceptions of Technology’s Usefulness in Community College General Education Courses

Educational institutions of all levels invest large amounts of time and resources into instructional technology, with the goal of enhancing the educational effectiveness of the learning environment. The decisions made by instructors and institutions regarding the implementation of technology are guided by perceptions of usefulness held by those who are in control. The primary objective of this mixed methods study was to examine the student and faculty perceptions of technology being used in general education courses at a community college. This study builds upon and challenges the assertions of writers such as Prensky (2001a, 2001b) and Tapscott (1998) who claim that a vast difference in technology perception exists between generational groups, resulting in a diminished usefulness of technology in instruction. In this study, data were gathered through student surveys and interviews, and through faculty surveys and interviews. Analysis of the data used Kendall’s Tau test for correlation between various student and faculty variables in various groupings, and also typological analysis of the transcribed interview data. The analysis of the quantitative data revealed no relationship between age and perception of technology’s usefulness. A positive relationship was found to exist between the perception of the frequency of technology use and the perception of technology’s effectiveness, suggesting that both faculty members and students believed that the more technology is used, the more useful it is in instruction. The analysis of the qualitative data revealed that both faculty and students perceive technology to be useful, and that the most significant barriers to technology’s usefulness include faulty hardware and software systems,lack of user support, and lack of training for faculty. The results of the study suggest that the differences in perception of technology between generations that are proposed by Prensky may not exist when comparing adults from the younger generation with adults from the older generation. Further, the study suggests that institutions continue to invest in instructional technology, with a focus on high levels of support and training for faculty, and more universal availability of specific technologies, including web access, in class video, and presentation software. Adviser: Ronald Joekel

Labyrinthum capellae. Le "Annotationes in Marcianum" di Giovanni Scoto Eriugena e la fortuna del neoplatonismo cristiano

The labyrinthum Capella quoted in the title (from a Prudentius of Troyes epistle) represents the allegory of the studium of the liberal arts and the looking for knowledge in the early middle age. This is a capital problem in the early Christianity and, in general, for all the western world, concerning the relationship between faith and science. I studied the evolution of this subject from its birth to Carolingian age, focusing on the most relevant figures, for the western Europe, such Saint Augustine (De doctrina christiana), Martianus Capella (De Nuptiis Philologiae et Mercurii) and Iohannes Scotus Eriugena (Annotationes in Marcianum). Clearly it emerges that there were two opposite ways about this relatioship. According to the first, the human being is capable of get a knowledge about God thanks to its own reason and logical thought processes (by the analysis of the nature as a Speculum Dei); on the other way, only the faith and the grace could give the man the possibility to perceive God, and the Bible is the only book men need to know. From late antiquity to Iohannes Scotus times, a few christian and pagan authors fall into line with first position (the neoplatonic one): Saint Augustine (first part of his life, then he retracted some of his views), Martianus, Calcidius and Macrobius. Other philosophers were not neoplatonic bat believed in the power of the studium: Boethius, Cassiodorus, Isidorus of Seville, Hrabanus Maurus and Lupus of Ferriéres. In order to get an idea of this conception, I finally focused the research on Iohannes Scotus Eriugena's Annotationes in Marcianum. I commented Eriugena's work phrase by phrase trying to catch the sense of his words, the reference, philosophical influences, to trace antecedents and its clouts to later middle age and Chartres school. In this scholastic text Eriugena comments the Capella's work and poses again the question of the studium to his students. Iohannes was a magister in schola Palatina during the time of Carl the Bald, he knew Saint Augustine works, and he knew Boethius, Calcidius, Macrobius, Isidorus and Cassiodorus ones too. He translated Pseudo-Dionysius the Areopagite and Maximus the Confessor. He had a neoplatonic view of Christianity and tried to harmonize the impossibility to know God to man's intellectual capability to get a glimpse of God through the study of the nature. According to this point of view, Eriugena's comment of Martianus Capella was no more a secondary work. It gets more and more importance to understand his research and his mystic, and to understand and really grasp the inner sense of his chief work Periphyseon.

Health risk appraisal for older people 4: case finding for hypertension, hyperlipidaemia and diabetes mellitus in older people in English general practice before the introduction of the Quality and Outcomes Framework

Early intervention can help to reduce the burden of disability in the older population, but many do not access preventive care. There is uncertainty over what factors influence case finding in older patients in general practice.

The Institutional Framework around Successful Art Forms in Communist Czechoslovakia

Mr. Michl posed the question of how the institutional framework that the former communist regime set up around art production contributed to the success of Czech applied arts. In his theoretical review of the question he discussed the reasons for the lack of success of socialist industrial design as opposed to what he terms pre-industrial arts (such as art glass), and also for the current lack of interest into art institutions of the past regime. His findings in the second, historical section of his work were based largely on interviews with artists and other insiders, as an initial attempt to use questionnaires was unsuccessful. His original assumption that the institutional framework was imposed on artists against their will in fact proved mistaken, as it turned out to have been proposed by the artists themselves. The basic blueprint for communist art institutions was the Memorandum document published on behalf of Czechoslovak visual artists in March 1947, i.e. before the communist coup of February 1948. Thus, while the communist state provided a beneficial institutional framework for artists' work, it was the artists themselves who designed this framework. Mr. Michl concludes that the text of the memorandum appealed to the general left-wing and anti-market sentiments of the immediate post-war period and by this and by later working through the administrative channels of the new state, the artists succeeded in gaining all of their demands over the next 15 years. The one exception was artistic freedom, although this they came to enjoy, if only by default and for a short time, during the ideological thaw of the 1960s. Mr. Michl also examined the art-related legislative framework in detail and looked at the main features of key art institutions in the field, such as the Czech Fund for Visual Arts and the 1960s art export enterprise Art Centrum, which opened the doors into foreign markets for artists.

Testing strategies and follow-up for coeliac disease in a general internal medicine outpatient department from 2000 to 2005

PRINCIPLES: Coeliac disease (gluten sensitive enteropathy) is a genetically determined disorder with an incidence in the general population that is comparable to type 2 diabetes mellitus. Awareness of this fact and of the often atypical and oligosymptomatic manifestations is only now gaining ground in the medical profession. A high index of suspicion is important in order to minimise diagnostic and therapeutic delay. METHODS: Testing patterns and follow-up for coeliac disease in our institution have been analysed retrospectively for the past five years. The current literature was reviewed with respect to recommendations for clinical practice. RESULTS: A total of 271 patients were tested for coeliac disease over a period of five years. Only in 24 patients were positive results found; after further work-up, the final number of cases with certain or presumed coeliac disease was four. Followup was often difficult, many patients being lost after a single visit. CONCLUSIONS: This study showed that the number of tests ordered in our institution, more often for abdominal than atypical symptoms, has started to increase in the past two years. It also showed that screening tests have found their place in general clinical practice, while the final choice of tests needs to be determined in accordance with available guidelines and local resources. Upper endoscopy with small bowel biopsy remains the gold standard for diagnosis, but its place in follow-up is less certain. Coeliac disease is a disorder for which there is a definite treatment (gluten free diet); if it is left untreated diminished quality of life and potentially serious complications may ensue. Further education of the medical profession regarding coeliac disease, its incidence, presentation and treatment, is clearly indicated..

Competencies in arts therapies: A rating of importance, training and performance by practitioners and referring professionals in Switzerland

This survey was conducted in developing a final specialized examination for all arts therapists in Switzerland by the Council of Swiss Arts Therapy Associations (CSATA). Forty-eight generic key competencies (GKC) were sent to all 1235 arts therapists in five different disciplines in Switzerland (response 47.5%) and to 384 referring professionals and employers (RPE) listed by therapists (response 42%). The mean importance of GKC was rated high (4 points of 5) by practitioners and RPE. Different opinions on importance of GKC in disciplines included artistic ability and psychotherapeutic relative to medical orientation. The training of competencies was rated lower by practitioners (3.48 points) and different in the eight competence categories and five disciplines. Areas of weak training were identified. The performance of GKC was rated by referring professionals equally to its importance (mean +0.3 points) and showed a good understanding of competencies by RPE. Judging of performance was difficult for RPE in more than 20% of items. The results provide criteria for detailed outcome assessments and the advancement of a final examination for arts therapists in Switzerland.

Life-patterns on the periphery : a humanities base for development imperatives and their application in the Chicago city-region

Life-Patterns on the Periphery: A Humanities Base for Development Imperatives and their Application in the Chicago City-Region is informed by the need to bring diverse fields together in order to tackle issues related to the contemporary city-region. By honouring the long-term economic, social, political, and ecological imperatives that form the fabric of healthy, productive, sustainable communities, it becomes possible to setup political structures and citizen will to develop distinct places that result in the overlapping of citizen life patterns, setting the stage for citizen action and interaction. Based in humanities scholarship, the four imperatives act as checks on each other so that no one imperative is solely honoured in development. Informed by Heidegger, Arendt, deCerteau, Casey, and others, their foundation in the humanities underlines their importance, while at the same time creating a stage where all fields can contribute to actualizing this balance in practice. For this project, theoretical assistance has been greatly borrowed from architecture, planning theory, urban theory, and landscape urbanism, including scholarship from Saskia Sassen, John Friedmann, William Cronon, Jane Jacobs, Joel Garreau, Alan Berger, and many others. This project uses the Chicago city-region as a site, specifically the Interstate 80 and 88 corridors extending west from Chicago. Both transportation corridors are divided into study regions, providing the opportunity to examine a broad variety of population and development densities. Through observational research, a picture of each study region can be extrapolated, analyzed, and understood with respect to the four imperatives. This is put to use in this project by studying region-specific suggestions for future development moves, culminating in some universal steps that can be taken to develop stronger communities and set both the research site specifically and North American city-regions in general on a path towards healthy, productive, sustainable development.

Strange Relations. Cultural Translation of Noh Theatre in Ezra Pound’s Dance Poems and W. B. Yeats’s At the Hawk’s Well

Drawing on the reception of Noh drama by Ezra Pound and William Butler Yeats, the article analyses both the literary and cultural ‘translations’ of this form of Japanese theatre in their works, focusing on Yeats’s play At the Hawk’s Well (1917). I conceptualize ‘cultural translation’ as the staging of relations that mark a residual cultural difference. Referred to as ‘foreignizing’ in translation theory, this method enables what Erika Fischer-Lichte has termed a ‘liminal experience’ for the audience –– an effect Yeats intended for the performance of his play. It evokes situations in which opposites collapse and new ways of acting or new combinations of symbols can be tried out. Yeats’s play will be used to sketch how an analysis of relations could serve as a general model for the study of cultural transfer as cultural translation in general. Keywords: cultural translation, translation theory, performance, William Butler Yeats, Itō Michio, Ezra Pound, At the Hawk’s Well