Utilization dimensions of gerontologic knowledge in the practice of community social politics

Although disenchantment between "science" and "practice" and complaints about the inadequate utilization of gerontological knowledge are often articulated, the problem of utilization of this knowledge in fields of practice has rarely been the topic of empirical research. By referring to the actual sociological debate about "utilization" the contribution tries to shed light on the complexity of the problem. It is important to realize that for too long utilization of knowledge, quite naively, has been looked at as a process of merely transferring true results in a "right" way. Instead, from a sociological point of view, one has to learn that the most decisive filter in selecting knowledge is represented by the context of utilization and that such contexts display their own specific logic or rationality in processing knowledge. Based on interviews in three German municipalities with employees of department of social planning, state ministries of social affairs, welfare associations and local projects on counselling about old age problems, this thesis is examined in the case of gerontological knowledge. A first partial evaluation of the material from this on-going research project confirms the relevance of this assumption.     

Significance of extrapancreatic findings in computed tomography (CT) of acute pancreatitis

Computed tomography (CT) has proven reliable in the early detection of acute haemorrhagic pancreatitis. In the present study the extrapancreatic changes at CT were studied in 60 patients with acute pancreatitis. The CT findings were correlated to the early "prognostic signs" by Ranson and the clinical course of the disease. All the patients with minor extrapancreatic changes recovered without complications. When moderate to severe extrapancreatic changes were seen the incidence of haemorrhagic pancreatitis and the risk of development of pseudocyst or abscess was high. In these patients a dynamic contrast enhanced CT should be done in order to select the patients with haemorrhagic pancreatitis.     

Value of cervical myelography in lateral cervical root compression

The roentgenograms of preoperative cervical metrizamide myelography performed in 133 patients who had undergone surgery for a lateral cervical root compression (foraminotomy) were retrospectively re-evaluated without knowledge of the findings at surgery. Detailed criteria of the radiologic root cavity recess were compared with details of findings at surgery, in order to check the value of the information provided by the myelogram with regard to the morphological nature of the root compression. A review of the two main categories--"soft prolapse with or without primary sequestrum" and "hard protrusion" revealed different myelographic findings. It was not possible to establish an unequivocal diagnosis in individual cases and with regard to forms of root compression exhibiting a greater degree of differentiation.     

Beeinflußt das geschlecht die zuweisung zur stationären psychiatrischen behandlung?

Zusammenfassung In Mannheim wurde im Jahre 1968 mit dem schrittweisen Aufbau eines gemeindenahen psychiatrischen Versorgungssystems begonnen. Bestandteil dieses Versorgungskonzepts sind Absprachen zwischen den beteiligten stationären Einrichtungen, die die Zuweisung der Patienten zur stationären Behandlung regeln. Eine modellgestützte, multivariate Analyse von Inanspruchnahmedaten einer Kohorte von 126 schizophrenen Patienten weist nach, daß die Ungleichverteilung der Geschlechter auf die Institutionen das Ergebnis dieser Absprache ist; dabei sind Krankheitsdauer und die Art der Zuweisung von entscheidender Bedeutung.Die vorliegende Arbeit entstand im Rahmen eines von der Deutschen Forschungsgemeinschaft geförderten Projekts im Sonderforschungsbereich 116 Psychiatrische Epidemiologie der Universität Heidelberg (Sprecher: Prof. Dr. Dr. M. Schmidt)     

Image quality assurance in x-ray diagnostic units. Information on DIN 6868 standard series

The Working Group for Standardisation justifies and comments on the establishment of a standard series for image quality assurance in X-ray diagnostic services (DIN 6868). In order to promote compliance with these standards, the users are given some background information on the structure of the standard series and on the recommended procedures to be followed. The definitions for the various hierarchically arranged tests, such as constancy test, status test, acceptance test as well as a definition for the term "base-line image quality" are explained.     

Systematic and local reactions during phlebography of the leg with special reference to postphlebographic complications. Randomized, prospective, intraindividual double-blind study of iopamidol and ioxithalamate (250 mg I/ml) using the 125I-fibrinogen test: II

The rate of positive 125I-fibrinogen accumulations after typical ascending phlebography was significantly less (9/40 = 23%) with iopamidol compared with ioxithalamate (16/40 = 40%). The iodine content of the contrast media used in this intraindividual study (40 patients) was 250 mg/ml. With the 125I-fibrinogen uptake accepted as a method of reference, the clinically observed postphlebographic symptoms of thrombophlebitis were false positive in 1/6 and false negative in 3/4 of the cases. These incidences were registered for both contrast media. With the lowered iodine content (250 mg/ml), too, pain reactions were seen in approx. 50% during the injection of the ionic agent, but in none of the cases using the non-ionic agent. Not one of the commercial contrast media can be regarded as "ideal" at this time. Nevertheless, it can be concluded, that non-ionic contrast media with iodine content of 250 mg/ml are highly effective in preventing acute and delayed reactions. Moreover, this concentration seems to be adequate for optimal imaging in phlebography.     

Increased concentration of hypoxanthine in human central cerebrospinal fluid after subarachnoid haemorrhage

Summary The adenine nucleotide metabolites hypoxanthine, xanthine and uric acid were determined by high performance liquid chromatography in cerebrospinal fluid (CSF) from 25 patients with subarachnoid haemorrhage (SAH) and from 26 control subjects. In addition, the haemoglobin and protein levels in the CSF of the patients were determined.In 13 subjects, from which lumbar CSF was collected three, six and nine days after SAH, there was a gradual increase in 8 patients for hypoxanthine and in 3 of the 13 patients for xanthine and uric acid. The mean concentrations were not significantly higher than the controls. In 12 SAH patients, consecutive CSF fractions of 10 ml were collected peroperatively during surgical clipping of aneurysms. The hypoxanthine concentrations increased continously from lumbar to central CSF samples. Hypoxanthine levels were 6.5±1.0 M in lumbar CSF compared to 11.8±2.3 M in central CSF (p<0.001), while xanthine, uric acid, haemoglobin and protein levels were equally distributed. Furthermore, the SAH patients showed about 3 times higher concentrations of central CSF hypoxanthine (p<0.01) and xanthine (p<0.05) while that for uric acid was similar compared to all control subjects. Also, an in vitro study showed that the increased concentrations of the adenine nucleotide metabolites could not be caused by degradation of blood components in the subarachnoid space.It is presumed that the increased central CSF concentrations of hypoxanthine that were demonstrated in patients after SAH could be a sensitive marker for brain tissue ischaemia. However, since there was no correlation between the hypoxanthine levels, clinical condition or cerebral vascular diameter, other factors have to be excluded before ischaemia alone could explain the elevated central hypoxanthine levels in patients without major clinical dysfunction after SAH.This study was supported by grants from Karolinska Institutet, the Swedish National Society against Heart and Chest disease, The Swedish Society of Medical Sciences, Wibergs Foundation, Boehringer Ingelheim and the Swedish Medical Research Council (proj. no. 7485).     

Personality traits and platelet MAO activity in alcohol and drug abusing teenage boys

The aim of this study has been to investigate whether teenage boys with mixed drug abuse differ from those with pure alcohol abuse as concerns personality traits and platelet monoamine oxidase activity. The series included 1129 consecutive 18-year-old males called to the Enlistment Center in the northern part of Sweden. A special inventory was constructed based on Zuckerman Sensation Seeking Scale (SSS), Eysenck's Personality Inventory (EPI), the Karolinska Scales of Personality (KSP) and questions about alcohol and drug consumption. The subjects with mixed drug abuse (n = 96) had high scores in the two subscales of SSS and KSP related to ability to stand boredom, high scores in both subscales of EPI and KSP related to impulsivity, high scores in Thrill and Adventure Seeking (TAS) and Experience Seeking (ES) of SSS as well as low platelet monoamine oxidase activity. The males with pure alcohol abuse (n = 33) also showed signs of monotony avoidance and impulsivity, but this type of abuse was not clearly related to low platelet monoamine oxidase activity and not to the aspects of curiosity included in the SSS such as TAS and ES. These findings are consistent with the picture earlier found as concerns "Type II" alcoholism which has an early onset, is genetically transmitted, is associated with mixed drug abuse and social complications.     

What do you say, agnostic?

This short novel is the story of the perplexity of a statistician travelling for more than a decade in the quicksands of quantitative psychopathology, from the nonvalidated concepts of the DSM-III to their validation by the Dexamethasone Suppression Test whose validity is ignored, from the "mathematical" concepts of Lacan to items suppressed from the AMDP-System, such as autism, because of a lack of agreement of the psychiatrists on objective criteria. The author concludes with a note of hope: comprehensive scales like the AMDP, combined with biological predictors, should facilitate the discovery of new psychotropic drugs, more specific for certain syndromes, hence contributing to new classificatory models.