The Significance of Posture in Communication Systems†

Abstract

We examined psychodynamic interview tasks and techniques to identify clinical actions that improve or impede exploration of subjects' emotional responses, conflicts, defenses, and central relationship themes. This article extends previous quantitative studies (Perry, Fowler, &; Greif, unpublished; Perry, Fowler, &; Semeniuk, 2005) by examining interview vignettes in 50—minute psychodynamic research interviews. We conducted qualitative analyses on 72 dynamic research interviews given by 26 subjects to delineate categories of tasks and interventions. Results indicated five broad tasks of the dynamic interview: 1) Frame Setting; 2) Offering Support; 3) Exploring Affect; 4) Offering Trial Interpretations; and 5) Providing a Formulation and Feedback of relationship themes and conflicts. We further selected two interviews each from 10 subjects, in which there was a difference of one standard deviation or greater on the Overall Dynamic Interview Adequacy scale (Perry, 1999), and interviewer errors from the Therapeutic Alliance Analogue scale (Perry, Brysk, &; Cooper, 1989). We utilized excerpts from these interviews to highlight the importance of these tasks and techniques in deepening discussion of dynamically meaningful material.     

Disclosing Medical Errors to Patients: It’s Not What You Say, It’s What They Hear

BACKGROUND  There is consensus that patients should be told if they are injured by medical care. However, there is little information on how they react to different methods of disclosure. OBJECTIVE  To determine if volunteers’ reactions to videos of physicians disclosing adverse events are related to the physician apologizing and accepting responsibility. DESIGN  Survey of viewers randomized to watch videos of disclosures of three adverse events (missed mammogram, chemotherapy overdose, delay in surgical therapy) with designed variations in extent of apology (full, non-specific, none) and acceptance of responsibility (full, none). PARTICIPANTS  Adult volunteer sample from the general community in Baltimore. MEASUREMENTS  Viewer evaluations of physicians in the videos using standardized scales. RESULTS  Of 200 volunteers, 50% were <40 years, 25% were female, 80% were African American, and 50% had completed high school. For designed variations, scores were non-significantly higher for full apology/responsibility, and lower for no apology/no responsibility. Perceived apology or responsibility was related to significantly higher ratings (chi-square, 81% vs. 38% trusted; 56% vs. 27% would refer, p < 0.05), but inclination to sue was unchanged (43% vs. 47%). In logistic regression analyses adjusting for age, gender, race and education, perceived apology and perceived responsibility were independently related to higher ratings for all measures. Inclination to sue was reduced non-significantly. CONCLUSIONS  Patients will probably respond more favorably to physicians who apologize and accept responsibility for medical errors than those who do not apologize or give ambiguous responses. Patient perceptions of what is said may be more important than what is actually said. Desire to sue may not be affected despite a full apology and acceptance of responsibility. Presented in part at the 28th Annual Meeting of the Society for General Internal Medicine, New Orleans, LA, May 11–14, 2005     

Parsing the phenotype of obsessive-compulsive tic disorder (OCTD): a multidisciplinary consensus

Obsessive-Compulsive Disorder (OCD) and Tic Disorder (TD) are highly disabling and often comorbid conditions. Of note, the DSM-5 acknowledged a new ‘tic-related’ specifier for OCD, which might be referred to as Obsessive-Compulsive Tic Disorder (OCTD), raising new interest toward a better clinical characterisation of affected patients. Available literature indicates that early onset, male gender, sensory phenomena and obsessions of symmetry, aggressiveness, hoarding, exactness and sounds as well as comorbidity with Attention Deficit Hyperactivity Disorder (ADHD) may be of more frequent observation in patients with OCTD. In order to share expertise in the field from different perspectives, a multidisciplinary panel of Italian clinicians, specifically involved in the clinical care of OCD and TD patients, participated into a consensus initiative, aimed to produce a shared document. As a result, after having examined the most relevant literature, authors sought to critically identify and discuss main epidemiologic, socio-demographic and clinical features characterising OCTD patients, along with other specific aspects including Health-Related Quality-of-Life (HRQoL), economic consequences related with the condition and its management, as well as treatment-related issues, that need to be further investigated.     

HLA-B*1832, a novel B allele was found through high-resolution HLA typing of a Spanish blood donor

In this paper, we describe the novel human leukocyte antigen (HLA)-B*1832 allele that we found in a female Spanish volunteer blood donor for clinical investigation during her high-resolution HLA typing. The HLA-B typing is B*1801 , 1832 , and the DNA sequence is homozygous with the exception characterized by a nucleotide exchange 'C' to 'A' at position 505, which, in consequence, replaced arginine at codon 169 (CGC) by serine in the new allele B*1832.