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Marjorie Nightingale Christiana Ibilola Awosan Katherine Stavrianopoulos 《Journal of family psychotherapy》2013,24(3):221-244
ABSTRACTThis article discusses unique considerations for a culturally sensitive emotionally focused therapy (EFT) for African American couples. EFT is an empirically supported treatment that significantly reduces relationship distress, yet efficacy with diverse populations remains unknown. African Americans’ chronic exposure to racism and discrimination creates a cumulative racial stress that negatively impacts their couple relationships. We propose a racially sensitive intervention for African American couples that addresses five considerations most salient for successful EFT treatment: the impact of racial stress, client trust of the therapist, gender-role expectations, and racial–gender views of emotionality and vulnerability. A case study illustrates this approach. 相似文献
63.
Dr. Gregory G. Kolden Marjorie H. Klein Timothy J. Strauman Sarah Chisholm-Stockard Erin Heerey Kristin L. Schneider 《Psychotherapy research》2013,23(3):165-177
Abstract In a prior study (Kolden & Klein, 1996), the authors found that the relationships between global personality pathology and early psychotherapy change processes (as defined by the Generic Model of Psychotherapy) were moderated by the extent of the patient's acute symptomatic and interpersonal distress. In the current study, the authors reanalyzed the same data to examine similarities and differences between personality disorder Clusters B (dramatic, emotional, or erratic) and C (anxious or fearful) in therapy process. In general, we found that more distressed patients reported greater defensiveness. There were no significant interactions between symptomatic distress and personality pathology in the prediction of any of the process variables. However, interpersonal distress moderated relationships between Clusters B and C and some therapy processes. Patients high in Cluster B felt more open and involved in the session when they were less distressed by their interpersonal problems at the start of therapy. In contrast, openness and insight were impeded among patients high in Cluster C when they were less distressed interpersonally. Therapists generally used more direct interventions and exploration of past experiences when working with patients higher in Cluster C pathology. However, therapists used direct interventions more specifically when patients with more severe Cluster B pathology were also higher in interpersonal distress. The discussion considers implications for the facilitation of productive early therapy process in patients suffering from Cluster B or C personality pathology. 相似文献
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Carline JD Curtis JR Wenrich MD Shannon SE Ambrozy DM Ramsey PG 《Journal of pain and symptom management》2003,25(1):19-28
This study investigated the specific physician skills required to interact with health care systems in order to provide high quality care at the end of life. We used focus groups of patients with terminal diseases, family members, nurses and social workers from hospice or acute care settings, and physicians. We performed content analysis based on grounded theory. Groups were interviewed. Two domains were found related to physician interactions with health care systems: 1) access and continuity, and 2) team communication and coordination. Components of these domains most frequently mentioned included taking as much time as needed with the patient, accessibility, and respect shown in working with health team members. This study highlights the need for both physicians and health care systems to improve accessibility for patients and families and increase coordination of efforts between health care team members when working with dying patients and their families. 相似文献
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Gabriela Gayer MD Marjorie Hertz MD Rivka Zissin MD 《Seminars in Ultrasound, CT and MRI》2003,24(5):377-386
Intussusception is rare in adults, in contrast to its frequent occurrence in infants. The clinical presentation is variable, consisting mainly of abdominal pain that may be chronic, intermittent, or acute. The classic triad of nausea and vomiting, bloody diarrhea, and an abdominal mass typically present in children with intussusception does not usually appear in adults. This diagnosis is, therefore, rarely included in the differential diagnosis of adult patients with vague abdominal complaints. However, with increasing use of CT scanning in the evaluation of patients with abdominal pain, the diagnosis of intussusception can be readily suggested by the radiologist because of its virtually pathognomonic appearance on CT. 相似文献
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Audrey Auclair Julie Martin Marjorie Bastien Nadine Bonneville Laurent Biertho Simon Marceau Frédéric-Simon Hould Simon Biron Stéfane Lebel Odette Lescelleur Jean-Pierre Després Paul Poirier 《Obesity surgery》2016,26(8):1717-1727
Background
Severe obesity is often characterized by ectopic fat deposition, which is related to development of type 2 diabetes (T2D). Thus, resolution of T2D may not be linearly associated with weight loss. The importance of ectopic fat reduction after bariatric surgery and T2D resolution is uncertain.Objective
The aim of this pilot study is to compare body composition and body fat distribution in severely obese patients with or without T2D after biliopancreatic diversion with duodenal switch (BPD-DS) surgery in relation to diabetes resolution.Methods
Sixty-two severely obese patients were evaluated at baseline, 6, and 12 months. Of these, 40 patients underwent BPD-DS surgery. Anthropometric measurements and abdominal and mid-thigh computed tomography scans were performed at each visit.Results
Before BPD-DS surgery, obese patients with T2D had higher weight as well as greater ectopic fat deposition in the abdomen and mid-thigh level than obese patients without T2D (p?<?0.05). Resolution of T2D was 65 and 90 % at 6 and 12 months, respectively. No difference in body composition changes at 6 and 12 months could be found between patients without T2D, patients with T2D resolution, and patients who remained T2D. Resolution of T2D was associated with a greater absolute loss of visceral adipose tissue (VAT) in comparison to patients without T2D (?1175?±?570 cm3 vs. ?729?±?394 cm3 at 6 months and ?1647?±?816 cm3 vs. ?1103?±?422 cm3 at 12 months; all p?≤?0.05).Conclusion
Ectopic fat mobilization, particularly the absolute loss of VAT, may play a major role in T2D resolution following BPD-DS surgery, regardless of the amount of weight loss.69.
Antibacterial activity and mechanism of action of a novel anilinouracil-fluoroquinolone hybrid compound 下载免费PDF全文
Butler MM Lamarr WA Foster KA Barnes MH Skow DJ Lyden PT Kustigian LM Zhi C Brown NC Wright GE Bowlin TL 《Antimicrobial agents and chemotherapy》2007,51(1):119-127
The anilinouracils (AUs) such as 6-(3-ethyl-4-methylanilino)uracil (EMAU) are a novel class of gram-positive, selective, bactericidal antibacterials which inhibit pol IIIC, the gram-positive-specific replicative DNA polymerase. We have linked various fluoroquinolones (FQs) to the N-3 position of EMAU to generate a variety of AU-FQ "hybrids" offering the potential for targeting two distinct steps in DNA replication. In this study, the properties of a hybrid, "251D," were compared with those of representative AUs and FQs in a variety of in vitro assays, including pol IIIC and topoisomerase/gyrase enzyme assays, antibacterial, bactericidal, and mammalian cytotoxicity assays. Compound 251D potently inhibited pol IIIC and topoisomerase/gyrase, displayed gram-positive antibacterial potency at least 15 times that of the corresponding AU compound, and as expected, acted selectively on bacterial DNA synthesis. Compound 251D was active against a broad panel of antibiotic-resistant gram-positive pathogens as well as several gram-negative organisms and was also active against both AU- and FQ-resistant gram-positive organisms, demonstrating its capacity for attacking both of its potential targets in the bacterium. 251D also was bactericidal for gram-positive organisms and lacked toxicity in vitro. Although we obtained strains of Staphylococcus aureus resistant to the individual parent compounds, spontaneous resistance to 251D was not observed. We obtained 251D resistance in multiple-passage experiments, but resistance developed at a pace comparable to those for the parent compounds. This class of AU-FQ hybrids provides a promising new pharmacophore with an unusual dual mechanism of action and potent activity against antibiotic-sensitive and -resistant gram-positive pathogens. 相似文献
70.
Academic writing is an important aspect of professional development for students and lecturers. It is one way in which they demonstrate their learning, but it can be a difficult skill to master. This article aims to enable students and professionals to develop their academic writing style using a coherent and effective framework. 相似文献