Essentially Winnicott: Creating Psychic Health

The authors of this paper recognize the paradox of identifying with the body of work of D. W. Winnicott as it was essential to his view that each analyst has to become the analyst s/he is or can be. This is to avoid the dead hand of conformity and falsity. Nevertheless his work continues to inspire creative use with its concern with health and those conditions for its development. Both authors find themselves committed to history taking, to needing and taking time, to a willingness to wait before interpreting, to a recognition that the self derives originally from a bodily state of unintegration, that the body remains significant for the expression of self‐states, to an understanding of aggression as not primarily associated with destructiveness, to attending to the state of mind in the analyst that encourages the establishment and maintenance of the analytic setting. Clinically their intention is to maintain a continuity within which psychic change can be facilitated, through an attention to the ongoing exchanges between both parties of the analytic relation. Several clinical examples are given from different settings to illustrate the presence of these tenets in their work.     

GeneXpert MTB/RIF Version G4 for Identification of Rifampin-Resistant Tuberculosis in a Programmatic Setting

A recent Cochrane review estimated GeneXpert MTB/RIF specificity for rifampin resistance as 98% (95% confidence interval [CI], 97 to 99), based on results from earlier test versions. The measured positive predictive value of the new generation test from programmatic implementation in Cape Town, South Africa, was 99.5% (95% CI, 98.5 to 100), confirming excellent specificity.     

Overall nutritional completeness (ONC): A new integrative measure of nutritional and agricultural performance quality of garden crops

In spite of increased efforts to integrate nutrition and agriculture there are relatively few methods developed to effectively do so in the design and analysis of agricultural interventions. In order to develop and test a method to link agricultural production and nutritional benefits, fall gardens were planted by researchers and low‐income households in five locations in the New River Valley, Virginia. Edible portion yield per square meter was calculated as a basic nutrition/agricultural yield measure. In order to use a more discriminating measure, crop nutrient yield equivalents (CNYE) for limiting nutrients (vitamins A and C, iron, and calcium) were calculated. The CNYE indicates the number of days that 100% of the USRDA would be supplied. Summing the CNYE scores across nutrients provided a ranking of the overall nutritional completeness (ONC) of the crops. The ONC ranking thus supplies a measure of yield and nutritional efficiency that can be adapted for different nutrition requirements and gardening conditions.     

City Parks: Untapped Resource for Fitness

In brief: Three tennis players had vague wrist pain when hitting the ball; all three were using the same racket model. Results of physical examination of the three patients were unremarkable, but x-rays of the tennis rackets showed a ‘fracture’ in the handle weights. Replacement of the racket with an identical new model relieved the symptoms in all the patients.     

Translational Research in South Africa: Evaluating Implementation Quality Using a Factorial Design

Background  

HealthWise South Africa: Life Skills for Adolescents (HW) is an evidence-based substance use and sexual risk prevention program that emphasizes the positive use of leisure time. Since 2000, this program has evolved from pilot testing through an efficacy trial involving over 7,000 youth in the Cape Town area. Beginning in 2011, through 2015, we are undertaking a new study that expands HW to all schools in the Metro South Education District.     

Business Invests in Employee Fitness

In 1894, John H. Patterson of the National Cash Register Company in Dayton, Ohio, introduced morning and afternoon exercise breaks for his employees. Ten years later he installed a gym on the fourth floor, and in 1911, he opened a 325-acre park for his employees. Every fall Americans watch the results of another company fitness program: the Green Bay Packers, originally an employee team sponsored by the Indian Packing Company in Green Bay, Wisconsin.

But it wasn't until about ten years ago that industry fitness programs really began to grow – in number and variety. They range from sessions led by interested employees to carefully controlled projects under full-time fitness directors. The facilities might be a local park or an elaborately equipped company gym. But reporters for The Physician and Sportsmedicine found that the programs had one theory in common: Increased fitness means increased production.     

Yo jyo hen shi ko, a novel Chinese herbal, prevents nonalcoholic steatohepatitis in ob/ob mice fed a high fat or methionine-choline-deficient diet.

BACKGROUND: Oxidative stress plays a role in the pathogenesis of nonalcoholic steatohepatitis (NASH). Yo jyo hen shi ko (YHK) is a complex compound purported to reduce reactive oxygen species (ROS) by blocking the propagation of radical-induced reactions. The aim of this study was to evaluate the role of the effect of YHK in experimental NASH. METHODS: NASH was induced in male ob/ob mice by a high-fat (HF) diet or methionine/choline-deficient (MCD) diet for 4 weeks. YHK-treated animals received YHK solution orally (20 mg/kg/day) in both experimental diets (n=6; each group) while control animals received only vehicle. RESULTS: The MCD and HF groups developed moderate diffuse macrosteatosis, hepatocellular ballooning, and a diffuse inflammatory infiltrate. With the addition of YHK, there was a marked reduction in macrosteatosis in both groups. This was associated with decreased lipoperoxide and reduced glutathione-GSH concentrations as well as reduced serum aminotransferases and improved histological markers of inflammation. These changes were also associated with weight loss in the MCD+YHK group and diminished weight gain in the HF+YHK group. CONCLUSION: YHK therapy blunts the development of macrosteatosis in these models of NASH and significantly reduces markers of oxidative stress. YHK also diminishes weight gain in this obesity prone model. Our findings warrant further study on the mechanisms involved with these effects.