Effects of parent loss: interaction with family size and sibling order.

The authors studied the effect of parent loss during the first 18 years of life and its interactions with family size and sibling order in a nonpsychiatric population of 247 men. Groups defined by loss type, family size, and sibling order were compared using MMPI scale scores. The results strongly suggest that parent loss and family size and their interaction have an important impact on adult personality traits as measured by MMPI scores. The strong adverse impact of intermittent loss and temporary loss in large families (much greater than that of permanent loss) is a crucial finding not previously noted in the literature.

Spore Yield and Microcycle Conidiation of Colletotrichum gloeosporioides in Liquid Culture.

The effect of V8 juice concentration (5 to 40%, vol/vol), spore inoculum density (10 and 10 spores per ml), and liquid batch or fed-batch culture condition on mycelium and spore production by Colletotrichum gloeosporioides was evaluated. The amount of mycelium produced, the time required for initiation of sporulation following attainment of maximum mycelium, and the time for attainment of maximum spore concentration increased with increasing V8 juice concentration in batch culture. Cultures containing V8 juice at >10% achieved a similar spore density (apparent spore-carrying capacity) of about 0.8 mg of spores per ml (1 x 10 to 2 x 10 spores per ml) independent of inoculum density and V8 juice concentration. The relative spore yield decreased from a high of 64% of the total biomass for the low-inoculum 5% V8 culture, through 13% for the analogous 40% V8 culture, to a low of 2% for the high-inoculum 27% V8 culture. Fed-batch cultures were used to establish conditions of high spore density and low substrate availability but high substrate flux. The rate of addition of V8 juice was adjusted to approximate the rate of substrate utilization by the (increasing) biomass. The final spore concentration was about four times higher (3.0 mg of spores per ml) than the apparent spore-carrying capacity in batch culture. This high spore yield was obtained at the expense of greatly reduced mycelium, resulting in a high relative spore yield (62% of the total biomass). Microcycle conidiation occurred in the fed-batch but not batch systems. These data indicate that substrate-limited, fed-batch culture can be used to increase the amount and efficiency of spore production by C. gloeosporioides by maintaining microcycle conidiation conditions favoring allocation of nutrients to spore rather than mycelium production.

Detection of ototoxicity from drugs applied topically to the middle ear space.

This paper summarizes data obtained from two separate studies done in our laboratory. Both studies were done to investigate the possibility that drugs commonly applied to the middle ear space could be the cause of sensori-neural hearing loss. The two drugs that were felt to be the most likely candidates for the studies were neomycin and polymyxin B. In the neomycin study, the various drug concentrations were administered three times a day for four weeks. In the polymyxin B study, the administration was three times a day for two weeks. Cochlear function was evaluated electrophysiologically and by examination of surface preparations of the organ Corti. The data show that both neomycin and polymyxin B can, in concentrations similar to those found in commercially available otic drops, induce cochlear damage when they are applied to the middle ear space of guinea pigs. The degree of damage produced is related. In the case of neomycin, it was shown that the effect worsens as the duration of the dosage administration is extended...

Models of the mind: their role in the clinical teaching of psychoanalytic psychotherapy.

In acquiring psychoanalytic ideas, psychotherapy trainees are often hampered by preconceptions about what constitutes a psychoanalytic perspective. These preconceptions can even constitute unarticulated models of pathogenesis and cure, which organize how trainees assimilate a supervisor's suggestions. We have identified two such models: the "passive-learning" model and the "cathartic" model. Realizing that trainees are operating under one of these models can help the supervisor to understand many of their errors. A traditional model emphasizing conflict and compromise formation addresses the deficiencies of these models and provides an initial framework for a psychoanalytic understanding of psychopathology and change. Certain guidelines for technique arise from this model: understanding rather than trying to change behavior, attending to the patient's emotional set, and using the therapist's emotional set. We describe one resident's use of the compromise-formation model to overcome an impasse in his treatment of a patient, and discuss some implications for clinical supervision.

Tax Reform Act of 1986: implications and trends.

The Tax Reform Act of 1986 contains several changes that substantially reduce economic flexibility for not-for-profit hospitals and healthcare systems. These changes, involving limited partnerships, investment tax credit, depreciation, and income deferral plans, among other items, carry several implications. Tax-motivated joint ventures will no longer be attractive to physician investors, donations to hospitals are expected to decline by up to 15 percent, and flexibility in attracting and retaining high-caliber employees is reduced. Efforts to reduce the federal budget deficit and renewed scrutiny of unrelated business income further jeopardize economic flexibility. Another threat is intensified Internal Revenue Service scrutiny of Form 990, which is filed by all not-for-profit organizations with $25,000 or more in annual gross receipts, and Form 990T, which is used to report unrelated business income. Measures to protect facilities' economic flexibility include careful return preparation, alternative recruitment tactics, objective opinions, refusal of high-risk deals, and outside appraisals.

Turn around or pull the plug? Lessons in hospital diversification.

Diversification has reached a crossroad. Ventures that are profitable or break even are likely to continue as such. For those which are not, management can divest through sale or liquidation or choose the "turnaround" route, which entails carefully and objectively appraising each diversification activity or entity. The initial step in a turnaround is to review the original strategic diversification objectives to determine if they remain valid. Next is a strategic overview and appraisal of the system's diversification activities. Specific, measurable objectives and action plans are necessary to guide the turnaround process. But even with the best turnaround plan, managers must anticipate the possibility of failure by establishing a "pull-the-plug" threshold. This is the point at which a venture's operating losses exceed the value of profits. Experience with successful turnarounds shows that corporate managers must consider the following steps: (1) the specialized skills and experience of the diversification activities' managers, (2) market-based volume and revenue projections, (3) downsizing space allocations, sharing space, or adding new services, (4) ways to keep from drowning in overhead, (5) appropriate organizational controls, (6) ways to improve patient access, (7) employee incentives, (8) use of equity capital, (9) effective management information systems, and (10) "sticking to the knitting."