Development and validation of the Workplace Interruptions Measure

In 3 studies, we developed and tested the first comprehensive, self‐report measure of workplace interruptions. The Workplace Interruptions Measure (WIM) is based on a typology of interruptions that included intrusions, distractions, discrepancy detections, and breaks. The four‐factor structure was reduced to a 12‐item measure in Study 1 (N = 317) and confirmed in a diverse sample of employees in Study 2 (N = 160). Study 3 (N = 323) further examined the psychometric properties of the WIM in a sample of university faculty and staff. Studies 2 and 3 demonstrated that both effort‐enhancing interruptions (intrusions, distractions, and discrepancy detections) and recovery‐enhancing interruptions (breaks) were associated with stressors and strains. Distractions, discrepancy detections, and breaks uniquely predicted strain outcomes beyond other workplace stressors (i.e., quantitative workload, interpersonal conflict, and role conflict). We discuss implications of the WIM for the theory and practice of interruptions research.     

Affilitative Trust-Mistrust and Immunity in Depressed Patients Receiving Supportive-Expressive Psychotherapy

This report examines the relationship between Affiliative Trust-Mistrust, an object-relations measure, and several quantitative immune measures in a sample of 27 depressed adults in short-term psychodynamic psychotherapy. Individuals with high Trust-Mistrust scores believe that they will be treated well by people with whom they are involved, whereas those with low scores expect to be abandoned, disappointed, or deceived. Patients with higher Trust-Mistrust scores at baseline had significantly higher natural killer (NK) cell percents at baseline, treatment termination, and a follow-up six months later. However, Trust-Mistrust was not associated with depression scores or four other immune measures that were examined. Trust-Mistrust did not moderate response to therapy in terms of changes in depression or immunity, although Trust-Mistrust did moderate the relationship between changes in depression and changes in NK percents during therapy. The magnitude of the relationship between Trust-Mistrust and NK cells was not diminished when other potentially confounding variables were controlled.In dieser Arbeit wird die Beziehung zwischen Vertrauen/Misstrauen, einem Indikator für die Gestaltung von Objektbeziehungen, und verschiedenen quantitativen immunologischen Massen in einer Stichprobe von 27 depressiven Erwachsenen geprüft, die sich in psychodynamischen Kurzzeitpsychotherpien befanden. Personen mit hohen Vertrauens-/Misstrauenswerten glauben, dass sie von Menschen, zu denen sie cine Beziehung aufgenommen haben, gut behandelt werden, während jene mit niedsrigen Werten eher erwarten, ausgenutzt, enttäuscht und verlassen zu werden. Patienten mit höheren Werten bei Therapiebeginn wiesen zum gleichen Zeitpunkt, am Ende der Therapie und bei einer 6-Monatskatamnese signifikant höhere Anteile von Natural-Killerzellen (NK) auf. Vertrauen/Misstrauen stand allerdings nicht in Beziehung zu Depressionswerten und zu vier anderen immunologischen Parametern, die in der Studie übrprüft wurden. Vertrauen/Misstrauen war darüber hinaus keine Moderatorvarible für das Ansprechen auf die Therapie im Hinblick auf Veränderungen der Depression und der Immunität, wenngleich die Variable die Beziehung zwischen Veränderungen der Depressivität und Veränderungen im Anteil von NK moderierte. Die Grösse der Bezichung zwischen Vertrauen/Misstrauen und den Natural-Killerzellen änderte sich nicht, wenn andere, potentiell konfundierende Variablen kontrolliert wurden.Le rapport examine la relation entre Confiance-Méfiance Affiliée, une mesure de relation d'objets, et plusieurs mesures quantitatives d'immunité dans un groupe de 27 adultes dépressifs suivant une thérapie psychodynamique à court terme. Les individus ayant des scores Confiance-Méfiance élevés croient qu'ils seront bien traitës par les gens qu'ils connaissent, alors que ceux qui ont des scores bas s'attendent à être abandonnés, trompés ou déçus. Les patients ayant pour ligne de base des scores Confiance -Méfiance élevés présentaient des pourcentages significativement plus élevés de cellules tueuses naturelles (natural killer + NK) en ligne de base, en fin de traitement et en suivi six mois plus trd. Cependant, Confiance-Méfiance n'était pas associé à des scores de dépression, ni à quatre autres mesures d'immunité qui ont été examinées. Confiance-Méfiance n'a pas diminué la réponse à la thérapie en termes de changements dans la dépression ou l'immunité, même si Confiance-Méfiance a contrôlé la relation entre les changements dans la dépression et ceux des pourcentages de NK pendant la thérapie. La magnitude de la relation entre Confiance-Méfiance et les cellules NK n'a pas été restreinte lorsque d'autres variables d'interférence ont été contrôlées.     

Intramedullary Sarcoidosis Presenting as Incomplete Paraplegia: Case Report and Literature Review

Abstract

Sarcoidosis is a chronic, multisystem noncaseating granulomatous disease of unknown etiology. Sarcoidosis typically presents clinically in individuals between the ages of 20 and 40 years. Although sarcoidosis most commonly affects the respiratory system, nearly any organ system can be involved. Spinal cord involvement by sarcoidosis is a rare event, occurring in less than 1% of patients with systemic disease. The case presented is that of a 29-year-old black male with benign past medical history who presented with a 6-week history of progressive incomplete paraplegia arid bowel dysfunction. Magnetic resonance imaging revealed an intramedullary mass at the T-4-T-5 levels. The patient underwent thoracic laminectomy and debulking of the mass. The pathology was consistent with granulomatous disease. Postoperatively, the patient was placed on prednisone. He subsequently received comprehensive inpatient and outpatient rehabilitation and at present is bowel and bladder continent and ambulating at community levels with a rolling walker. The diagnosis of sarcoidosis; potential treatment options, including debulking and long-term steroid use; and prognosis will be discussed.     

Systematic review of primary osseointegrated dental implants in head and neck oncology

The aim of this paper is to provide a systematic review of articles concerning primary osseointegrated dental implants in the head and neck oncology setting. We searched MEDLINE (1950 to March 2009) and Embase (1980 to March 2009) using the terms head and neck, oral, maxillofacial, craniofacial, jaws, mandible, maxilla, zygoma, dental implants, osseointegrated implants, implants, tumour, cancer, oncology, immediate, simultaneous, and primary. Two authors independently reviewed the abstracts, and all those written in the English language that referred to the placement of primary dental implants in patients with cancer of the head neck were included. Articles that referred to craniofacial or extraoral implants were excluded. Of 892 abstracts 83 were eligible for further consideration; the full articles were evaluated, and 41 that complied fully with the inclusion criteria are presented as a tabulated summary. There are three case reports, 13 reviews, and 25 clinical studies. Eight of the clinical studies refer solely to the insertion of dental implants at the time of primary oncological resection, and only two were of a prospective design. We have concisely summarised publications concerning primary dental implants, and our findings will help to inform head and neck cancer teams, particularly oncological surgeons, restorative dentists, and maxillofacial prosthodontists of the evidence base surrounding this approach to oral rehabilitation.     

Intravenous gammaglobulin treatment of chronic idiopathic thrombocytopenic purpura

High-dose intravenous gammaglobulin (IVIgG) was given to 12 children and adults with chronic idiopathic thrombocytopenic purpura (ITP) to avoid splenectomy or because they either failed to respond to or required maintenance with high doses of steroids and/or immunosuppressives. The average platelet count increase to initial therapy was 239,500/microliters (range 23,000-790,000). A concomitant IgG Fc receptor blockade, measured by IgG-sensitized 51Cr-labeled autologous erythrocytes, was seen in 11 of 11 patients tested, both splenectomized and not splenectomized, lasting 3-4 wk. Six or more months after treatment, 2 children are in remission, 2 children and 2 adults are stable requiring no therapy with platelet counts of approximately 50,000 and 30,000, respectively, 3 children require maintenance IVIgG therapy at 2-10-wk intervals, and 1 child and 2 adults have become refractory to further IVIgG. Splenectomy was not performed in 4 children. Two adults were able to discontinue daily prednisone. The 3 patients who became unresponsive to Swiss Red Cross gamma-globulin (IgSRK) therapy did so in conjunction with a markedly elevated platelet-associated IgG and IgM. Serum IgM increased an average of 103 mg/dl after the IVIgG infusions. No significant side effects were seen.