Length of Inpatient Stay and Jesness Inventory' Scores of Hospitalized Adolescent Psychiatric Patients

Data from an exploratory study examining the utility of the Jesness Inventory for characterization of adolescent psychiatric patients are presented. In a heterogeneous series of thirty-two hospitalized teenagers, positive and significant correlations were found between the Withdrawal and Social Anxiety Scales of inventory and the length of hospital stay. The total number of scale elevations over T-70 was also significantly correlated with length of stay. The authors describe a rationale and potential benefits for clinical study and use of the Jesness Inventory as an assessment device in adolcsccnt residential settings.     

Depersonalization Disorder: Dissociation and Affect

ABSTRACT

Dissociation and affect are intimately related constructs, but their relationship has not been subjected to extensive empirical study. This report investigates the relationship between dissociation and affect in depersonalization disorder. Fifty-six participants with DSM-IV depersonalization disorder (DPD) and 22 healthy comparison participants (HC) were administered the Dissociative Experiences Scale, the Multidimensional Anger Inventory, and the Spielberger Trait Anxiety Inventory. A subgroup of participants also completed the Affect Intensity Measure and the Boundary Questionnaire. Individuals with depersonalization disorder experienced more anxiety, anger, negative affect intensity, and thinner boundaries than healthy individuals, but did not differ in positive affect intensity. Within the DPD group, severity of pathological dissociation and of depersonalization were more strongly related to greater anxiety than to greater anger. The DPD group had higher negative than positive affect intensity, whereas in the comparison group opposite valences were of comparable intensity. In the combined sample, anxiety was the strongest predictor of depersonalization and pathological dissociation, anxiety followed by anger predicted absorption, while anger predicted amnesia. Our overall findings suggest that, at least in depersonalization disorder, pathological dissociation is more intimately related to anxiety than to anger. The findings also suggest that chronic depersonalization is a poor regulator of affect, since it is associated with persistent chronic elevations in frequency and intensity of negative affect. More elaborate research into the relationships between affect and dissociation would be fruitful.     

Catching and correcting near misses: The collective vigilance and individual accountability trade-off

Despite the focus on patient safety and quality health care for the last two decades, there is still limited understanding of how interprofessional interactions at an organizational or work unit level influence how clinicians perceive and respond to safety events and errors. Within the rubric of safety events, there has been a growing interest in near misses as precursors to adverse events in health care. Given the interactive nature of the variety of professionals working together in the delivery of health care, understanding how the different clinicians experience and respond to near misses in practice is important. A constructivist grounded theory approach was employed for this study which included semi-structured interviews with 24 participants in a large teaching hospital in Canada. Findings from this study provide a deeper understanding into how different clinicians experience and respond to near misses in clinical practice. This understanding indicates that collective vigilance can potentially create risk by eroding individual professional accountability through reliance on other team members to catch and correct their errors. Further research is needed to explore in more depth the trade-offs between collective vigilance and individual accountability by relying on others to catch and correct the potentially harmful errors and avert negative outcomes.     

Setting boundaries: A strategy for precarious ordering of women's caring demands

Under the conditions of health care reform, women increasingly are being called upon to assume caring responsibilities. There is little research about the process of women's caring. The findings of this feminist grounded theory study of women caring in diverse situations reveal the strategies women use to manage the dissonance created by caring demands. The strategy of setting boundaries, and subprocesses of determining legitimacy and attending to one's own voice provide an explanation of the processes employed by women to limit the number and extent of caring demands and to draw on self-knowledge to order their caring. This explanatory framework has potential to guide the practice of nurses and other health professionals working with women caring for themselves and others. In addition, these findings contribute to understanding the place of reciprocity, commitment, and affection in the phenomena of caring. © 1998 John Wiley & Sons, Inc. Res Nurs Health 21: 39–49, 1998     

Experiments for isolated-word recognition with single- and two-layer perceptrons

Several design strategies for feed-forward networks are examined within the scope of pattern classification. Single- and two-layer perceptron models are adapted for experiments in isolated-word recognition. Direct (one-step) classification as well as several hierarchical (two-step) schemes have been considered. For a vocabulary of 20 English words spoken repeatedly by 11 speakers, the word classes are found to be separable by hyperplanes in the chosen feature space. Since for speaker-dependent word recognition the underlying data base contains only a small training set, an automatic expansion of the training material improves the generalization properties of the networks. This method accounts for a wide variety of observable temporal structures for each word and gives a better overall estimate of the network parameters which leads to a recognition rate of 99.5%. For speaker-independent word recognition, a hierarchical structure with pairwise training of two-class models is superior to a single uniform network (98% average recognition rate).     

Expression of the zebrafish CD133/prominin1 genes in cellular proliferation zones in the embryonic central nervous system and sensory organs

The CD133/prominin1 gene encodes a pentamembrane glycoprotein cell surface marker that is expressed in stem cells from neuroepithelial, hematopoietic, and various organ tissues. Here we report the analysis of two zebrafish CD133/prominin1 orthologues, prominin1a and prominin1b. The expression patterns of the zebrafish prominin1a and b genes were analyzed during embryogenesis using whole mount in situ hybridization. prominin1a and b show novel complementary and overlapping patterns of expression in proliferating zones in the developing sensory organs and central nervous system. The expression patterns suggest functional conservation of the zebrafish prominin1 genes. Initial analyses of prominin1a and b in neoplastic tissue show increased expression of both genes in a subpopulation of cells in malignant peripheral nerve sheath tumors in tp53 mutants. Based on these analyses, the zebrafish prominin1 genes will be useful markers for examining proliferating cell populations in adult organs, tissues, and tumors. Developmental Dynamics 239:1849–1857, 2010. © 2010 Wiley‐Liss, Inc.     

Coparenting Relationships After Divorce: Variations by Type of Marital Violence and Fathers’ Role Differentiation*

Abstract: Using grounded theory methods, we examined coparenting relationships for 25 divorced mothers who experienced violence during their marriages. How well former husbands were able to differentiate, or keep separate, their parental and spousal roles emerged as central to coparenting dynamics and was partly related to type of marital violence. Linking differentiation to types of martial violence advances our theoretical understanding of variations in coparenting relationships after divorce. Results can be used to more effectively match divorcing parents with appropriate interventions.     

Lost in the crucible of supportive clinical supervision: supervision is not therapy

Clinical supervision as a mechanism that supports both professional and personal development is a concept that has captured the imagination of nurses. Though nurses generally agree that 'supervision is not therapy', a clear distinction cannot be enunciated between these two processes when both aim at personal growth. In combining personal and professional growth, the rationale for clinical supervision is unnecessarily confused, with the unfortunate result that supervision may, unwittingly, become a form of therapy for nurses. This paper examines a model of supportive clinical supervision qua Chambers and Long's example of a facilitative therapeutic supervisory style, that reflects nurses' conceptualization of clinical supervision as enhancing personal and professional growth. However, it could be argued that this stance is in crucial respects incorrect, and needs to be rethought if clinical supervision is to be established as credible in nursing. Subsequently, it is important to remember that the utilization of certain techniques rather than their stated goals, will dictate the form that supervision, or therapy, will take. The purpose of this paper is to demonstrate the logical unacceptability in combining two processes as one, while developing a conceptual framework that differentiates supervision from therapy.