Contingency interaction analysis in psychotherapy.

This article introduces (a) a computerized coding procedure that rates words and utterances in terms of emotion, cognition, and contract and (b) a contingency method of analyzing verbal interactions. Using transcripts of sessions conducted by 3 master therapists with 1 client, the rating procedure and contingency correlation analyses supported the study's hypotheses. Therapists' utterances were characterized by significantly different amounts of emotion, cognition, and contracts, indicating that communication styles varied in the relative emphasis placed on these attributes. Differences suggest that the therapists responded differently to emotional, cognitive, and contract utterances and that the client's responses were different across the 3 therapist interviews. Split halves of the interviews within therapists and within client sessions were not different, providing further evidence of reliability of the coding and contingency procedures.

Performance and carcass characteristics of swine when fed diets containing canola oil and added copper to alter the unsaturated:saturated ratio of pork fat.

A 3 x 2 trial was conducted to determine the effects of adding canola oil (0, 5, or 10%) and copper sulfate (0 or 250 ppm Cu) to diets of growing-finishing swine on performance, carcass characteristics, and carcass fat fatty acid composition. The trial used 180 pigs (27 kg). Grower diets (.80% lysine for 0% canola oil diet) were given from 27 to 57 kg of BW and finisher diets (.64% lysine) from 57 to 102 kg. Diets were formulated to constant ME:lysine ratio within the grower and finisher phases. Over the entire growing-finishing period, the addition of canola oil to the diets resulted in linear improvements in rate of gain (P less than .05) and feed efficiency (P less than .01). Dietary additions of canola oil had no effect (P greater than .10) on resulting backfat thickness or longissimus muscle area but resulted in reductions (P less than .01) in loin marbling and color and carcass fat firmness, mostly noted in pigs fed the diets with 10% canola oil. Canola oil additions at 5 and 10% levels, respectively, resulted in a 23 and 37% reduction (P less than .01) in saturated fatty acids, 3 and 8% increase (P less than .01) in monounsaturated fatty acids, and 37 and 77% increase (P less than .01) in polyunsaturated fatty acids in the carcass fat compared with the diets without canola oil. The addition of canola oil to diets of growing-finishing swine had a favorable influence on animal performance and on increasing the unsaturated:saturated ratio of the carcass fat.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of cimaterol for finishing swine including a drug withdrawal period.

One hundred fifty crossbred pigs (55 kg) were allotted by weight, sex and litter to a randomized complete-block design with five dietary treatments, six blocks per treatment and five pigs per pen with sex equalized across treatments. Corn-soybean meal-based diets (.65% lysine) with 0, .25 and .5 mg/kg cimaterol were fed, on an ad libitum basis, to pigs slaughtered at an average pen weight of 104 kg/pig. Drug withdrawal prior to slaughter was 1, 3 and 5 d for pigs fed cimaterol at .25 mg/kg and 1 d for those fed cimaterol at .5 mg/kg of diet. Dietary cimaterol level influenced (quadratic, P less than .01) average daily gain during the first 42 d on test; however, daily feed intake and feed conversion ratio were not affected (P greater than .1). Pigs fed .25 mg/kg cimaterol with a 1-d drug withdrawal had 6.8, 7.7 and 13.5% less 10th rib fat depth and 11.1, 6.1 and 13.3% less P2 fat depth than those subjected to either a 3- or 5-d drug withdrawal or those fed the 0 mg/kg cimaterol diet (control), respectively. Overall, pigs fed cimaterol had 7.9% larger longissimus muscle area and 2.6% more kilograms of muscle than pigs fed the control diet. Cimaterol fed at .5 mg/kg resulted in higher (P less than .05) Warner-Bratzler shear force values and altered the proportion of saturation in some long-chain fatty acids, although the total saturated:unsaturated fat ratio was not affected. Pigs fed no cimaterol had less thaw loss (P less than .05) than did those fed other treatments.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of feeding high-oleic-acid peanuts to growing-finishing swine on resulting carcass fatty acid profile and on carcass and meat quality characteristics.

A high-oleic-acid peanut breeding line was used in a study designed to determine the effects of feeding swine diets containing elevated levels of monounsaturated fatty acids as a means to increase the level of monounsaturates and total unsaturates in the resulting carcass fat. Forty-eight pigs were allotted to four treatments that consisted of corn-soybean meal diets that contained 1) high-oleic peanuts (HOP), 2) regular commercial peanuts (RP), or 3) canola oil (CO), each added at a dietary level to provide 10% added fat/oil, and 4) a control diet with no added fat/oil. The oil of HOP averaged 75% oleic acid vs 60% for CO and 53% for RP. The pigs were fed the experimental diets from 33 to 102 kg BW, after which all pigs were slaughtered. All three dietary oil sources resulted in increases (P < .01) of monounsaturates in the backfat; the HOP diet resulted in the greatest increase (32% greater than control). Both CO and RP increased (P < .01) the level of polyunsaturates by nearly twofold; HOP resulted in a small decrease. Total unsaturates increased (P < .01) by 24, 24, and 27% for HOP, RP, and CO treatments, respectively, over that obtained from the control treatment. Carcass fat was softer/oilier (P < .05) from pigs fed CO and RP diets, but not from those fed HOP diets, compared with carcass fat of pigs fed the control diet. Dietary fat/oil source had no effect (P > .05) on other carcass compositional traits and various meat quality attributes.(ABSTRACT TRUNCATED AT 250 WORDS)

Enhancing CEOs' decision making through information systems.

Although healthcare management information systems significantly enhance the decision-making capacity of the chief executive officer (CEO), some CEOs make limited use of this potentially powerful management ally. A central management issue is finding the optimal fit between the CEO's roles and responsibilities and the capacity of information systems to adapt to and support these functions. Thus data system designers must clearly understand the CEO's needs, management tasks, and unique responsibilities. An often misunderstood concept is that data by themselves are not immediately useful and applicable to managerial needs. To become useful information, data must be timely, accurate, relevant, and actionable. CEOs may be disappointed with management information systems because of an inherent conflict between what the computer can do best--rapid, routinized solutions--and what top management usually requires. The CEO's decisions are generally singular, and the system's data may not be structured to serve those decision-making requirements. Building a system that is responsive to the CEO's needs requires an equal partnership between the CEO, data manager, and system designer. The CEO also must be willing to invest a lot of time in shaping the facility's system. In addition, because of the considerable and escalating cost of developing, using, and maintaining organizational data systems, CEOs must assess the cost/benefit ratio of obtaining additional information from existing data bases.

The financial status of Catholic hospitals: 1982-1983.

Recently available figures for 1982 and 1983 show that Catholic hospitals as a whole attained positive ratios of net income to fund balances and that these gains exceeded inflation in both years. The financial picture varies, however, when data for specific categories of Catholic hospitals are examined. For example, smaller hospitals relied more on borrowed funds to finance assets and generate profits, and for many of them these profits still did not exceed the 1983 inflation rate. Hospitals particularly vulnerable to diagnosis-related group payment--that is, teaching hospitals, hospitals with negative operating income, and hospitals adding beds--possessed less liquidity than Catholic hospitals aggregately. Hospitals in each of these categories experienced less-than-average basic profitability as well.

Should health care managers adopt Theory Z?

Health care administrators should carefully consider the situations in which they apply management methods used in industry, since such methods may not be effective in motivating certain groups of hospital employees. Physicians, for example, may display little loyalty to the health care organization, even though as a group they exert significant influence on policies, standards, and administration. As a result, management styles such as Theory Z that focus on holistic concern, individual decision-making responsibility, and long-term employment guarantees may fail to interest them. Nurses also may be reluctant to commit themselves to an organization because of the high rate of turnover in their profession in recent years. Support staff, however, probably would be receptive to management techniques that offer security through long-term employment guarantees. Other factors necessary for the effective use of Theory Z industrial management techniques are a clear hierarchy with well-defined reporting relationships, moderately specialized career paths, and trust among employees that the organization's concern for their welfare is genuine. The key consideration, however, in applying any theory is that only those aspects which best serve the organization's needs should be adopted.

Hypnosis as an adjunct in management of pain.

Hypnosis in the management of intractable pain is a valuable but frequently overlooked tool for the practicing physician. Two cases are presented which illustrate some of the benefits and limitations of hypnosis in pain management. Hypnosis is most effective when the patient is motivated, and pain is a strong motivating force. Secondary gain from the pain and underlying psychiatric illness must be considered when seemingly routine pain problems do not respond to hypnosis. Hypnosis may be equally effective for pain of organic or psychogenic origin. Ancillary benefits from hypnosis may include a diminution of secondary anxiety and depression. The technic is impractical for some patients because of the time requirements, but proper patient selection can obviate much of this objection. Self-hypnosis and/or the supervised use of a relative as a substitute for the physician enhances effectiveness. Training in hypnosis for adjunctive use in the management of pain is available to primary care physicians.

Ternary copper (II) complexes containing salicylate and nitrogenous chelates such as histamine.

In the introduction the chemistry of some bivalent copper complexes of aspirin and salicylate is briefly reviewed and the biological importance of mixed-ligand complexes of bivalent copper is illustrated. The nature of hydroxy-bridged copper (II) complexes and their possible role in the physiological activity of histamine is also discussed. Several neutral, insoluble copper (II) complexes of the type (Chelate-Cu-salicylate) 0-lambda H2O where chelate = 1, 10-phenanthroline (phen), chi = 1; 2,2'-bipyridyl (bipy), chi = 2; histamine (Ha), chi = 1; and where salicylate (sal) = dianion of salicylic acid have been prepared for the first time. They have been characterised by physico-chemical methods and the role of binuclearhydroxy-bridged copper (II) complex ions in their formation is demonstrated. Such complexes may be relevant to the pharmacological action of histamine and of the salicylates, the copper complexes of which are potential anti-inflammatory drugs. Results of some in vivo experiments that have been carried out with mice are also presented.

An investigation of the therapeutic value of the 'copper bracelet'-dermal assimilation of copper in arthritic/rheumatoid conditions.

From over 300 arthritis sufferers, half of whom previously wore 'copper bracelets', three treatment-group-subjects were randomly allocated for a psychological study. This involved wearing 'copper bracelets' and placebo bracelets (amodised aluminum resembling copper) alternately. These groups, as also a control group, answered questionnaires. The copper bracelets were weighed before and after use. Preliminary results show that, to a significant number of subjects, the wearing of the 'copper bracelet' appeared to have some therapeutic value. A study of the components of sweat and the solubility of copper in sweat was carried out. In five sweat samples, the copper concentration was of the order 2 x 10(-5) M and after equilibrating with copper turnings at room temperature for 24 hours the samples turned blue in colour and contained approximately 2 x 10(-3) M copper. The permeability of skin to copper containing solutions has also been discussed. It has also been shown that the wearing of a 'copper bracelet' results in a weight loss in excess of the body's total burden of copper (100-150 mg). A pair of copper bracelets lost 80 mg in 50 days when worn around the ankles and a copper bracelet worn around the wrist also lost about 90 mg in that time.

Perfusion of intact skin by a saline solution of bis(glycinato) copper(II).

The perfusion of intact cat skin by a saline solution of bis(glycinato) copper(II), labelled with Cu64, has been studied in a diffusion cell. It has been shown by counting the activity that the copper(II) complex perfuses the skin and over a period of 6-7 hr reaches the isotonic saline solution underneath. After this inaugural delay period a steady rate of penetration was maintained and after 24 hr about 1 mg of the complex perfused the skin. Skin samples, taken before and after, were fixed in buffered formalin and embedded in paraffin. Five micron sections were taken, stained with rubeanic acid and counterstained with 1% Eosin Y solution. Histological examination showed that copper was present in all layers of the perfused skin. This work is relevant to the solubility of metallic copper in human sweat and to the possible therapeutic value of the "copper bracelet".

The 1979 CHA survey of pastoral care programs.

Pastoral care programs have grown and matured in the 10 years since The Catholic Hospital Association and the National Association of Catholic Chaplains issued their "Guidelines for Establishing a Department of Religion in a Catholic-Sponsored Hospital." CHA's 1979 survey of 370 institutions points out that while pastoral care departments are recognized as important, budgets for personnel and programs are unrealistic. The shortage of pastoral care personnel is an acute challenge to Catholic facilities, and alternative staffing methods must be sought.

Copper and inflammation.

Bonta, Sorenson and others have shown that Cu(II) derivatives are effective anti-inflammatory agents. Some chemical and pharmacological properties of Cu(I) and metallic Cu are discussed. Thio complexes of Cu(I) were prepared and shown to be useful anti-inflammatory agents in rats. Hypotheses are stated concerning the possible therapeutic value of copper in its various oxidation states.

Prevalence of depersonalization and derealization experiences in a rural population.

BACKGROUND: Dissociative symptoms are common psychiatric symptoms whose prevalence in rural (agricultural) populations is unknown. The present study examines the prevalence of depersonalization and derealization experiences in a southern rural US population as well as socio-demographic and emotional factors associated with these experiences. METHOD: A random sample of 1008 adults in rural eastern North Carolina completed a survey by telephone, which included questions about experiences of depersonalization or derealization in the past year. Demographic information was gathered on all respondents; for those reporting these dissociative experiences, information on their frequency, duration, and whether they occurred during conditions of danger, severe stress, upsetting memories, nervousness or depression, or for no apparent reason was also elicited. RESULTS: The reported prevalence rates were 19.1% for depersonalization, 14.4% for derealization, and 23.4% for either dissociative experience. Logistic regression showed that women reported a significantly higher rate of dissociative experiences (26.5%) than men (19.5%), (Odds Ratio = 1.93, 95% CI = 1.37-2.74), particularly African-American women (29.9%). Experiencing chronic pain (OR = 2.96, 95% CI = 2.05-4.28) and irregular church attendance (OR = 1.18, 95% CI = 1.07-1.31) were also associated with increased frequency of dissociation. Increasing age (OR = 0.73, 95% CI = 0.65-0.81) and being employed (OR = 0.58, 95% CI = 0.39-0.86) were associated with reduced frequency of dissociation. Pain, gender, and age were related to both depersonalization and derealization experiences. Employment and church attendance were related to depersonalization experiences, while ethnic minorities experienced more derealization. CONCLUSIONS: A predominantly southern rural population reported a high 1-year prevalence of depersonalization and derealization experiences. The prevalence of dissociation experiences was common in this southern sample, as was found by Ross and colleagues (1990) in an urban population in Canada. Risk factors for depersonalization and derealization experiences had considerable overlap, but differed on several variables suggesting different underlying mechanisms.

Faucial bonorrhoea.

Nine hundred patients (250 females and 650 males) attending the Clinic for the Treatment of Venereal Diseases had throat swabs taken as a routine; 1-1% (1-6% of females and 0-92% of males) were found to have faucial gonorrhoea. This figure appears to be similar to that found by Odegaard and Gunderson (1973) in Norway. The treatment regime used in the clinic in Perth appeared to be satisfactory, as there were no failures. It is stressed that all patients suspected of suffering from venereal disease should have their throats swabbed as a routine. Information as to whether or not oral sex is practised should be obtained.

A zomepirac reaction mimicking ectopic pregnancy.

A case is presented of a 29-year old woman who developed sudden onset of abdominal pain, vomiting, near syncope, abdominal tenderness, profound hypotension, and a late menstrual period. The patient was in good health and her only medication was zomepirac for musculoskeletal discomfort. An exploratory mini-laparotomy was performed for the suspicion of a ruptured ectopic pregnancy, but no evidence of hemoperitoneum or of ectopic pregnancy was found. A subsequent pregnancy test was negative, and the episode was attributed to a zomepirac reaction. A review of zomepirac and zomepirac reactions is included.