Time in Motion: Qualities of Temporality Within Psychotherapeutic Psychodynamic Counselling

Our relationship to time is both a developmental and a relational one; an inter- and intra-psychic experience. Exploring how the theories of Freud, Klein, Winnicott, and their successors offer explanations of how the psychoanalytic subject develops and sustains a concept of time and the factors that may hinder this, this essay suggests that different qualities of time, such as continuity, rhythm, repetition and interruption, can reveal themselves through the client's transferential and countertransferential relationship with the therapist. Using fictionalized clinical examples it explores how a bodily felt experience of time was thought about by the therapist/author using Laban movement analysis to support a client in ‘working through’ early material that felt stuck. The exploration of a client's perspective is brought in through the writings of the activist Passerini on her psychoanalytic treatment (cited by Baraitser in Enduring Time) and her experience of trauma's capacity to stop time. The essay also looks at how psychoanalytic ideas of temporality challenge the ‘recruiting’ of time by the wider culture to create more time-efficient late-capitalist subjects but by using ideas from movement studies and a Lacanian influenced time register it is suggested that cultural attacks on subjective experiences of temporality could be challenged within therapy. It is hoped the essay encourages the therapist to become alert to the manifestations of different temporal experiences within the therapeutic relationship and to develop a creative, embodied language with which to explore it with the client.     

Motor speed and reaction time in HIV/AIDS patients: a case-control study

HIV infection can produce a range of cognitive and behavioural symptoms that become more frequent and severe as the immune system deteriorates. This case-control study assessed the reaction time and the motor speed of Nigerian Africans with HIV or AIDS using the simple reaction time and finger-tapping tasks, and correlated their performances with their CD4 levels. A total of 288 age-, sex-, and level of education-matched subjects, comprising 96 HIV-positive patients with symptomatic illness, 96 HIV-positive patients with asymptomatic infection, and 96 HIV-negative controls, participated in the study. The mean CD4 cell counts of the controls, HIV-positive asymptomatic subjects, and HIV-positive symptomatic subjects were 682 ±44, 284 ±62 and 142 ±36, respectively (p < 0.05). There was no significant difference in the reaction time and motor speeds of the asymptomatic HIV-positive subjects and the controls (p > 0.05), but there was significant prolongation of reaction time and reduced finger taps among the symptomatic HIV-positive subjects (p < 0.01). The cognitive performance was worse in subjects with CD4 cell counts less than 200/μl as compared with subjects with CD4 cell counts greater than 200/μl. We conclude that there is no significant prolongation of reaction time and reduced motor speed in asymptomatic HIV-positive individuals but there is a definite cognitive deterioration with progressive reduction in CD4 levels.     

Advances in Percutaneous Coronary Interventions for Elderly Patients

Coronary heart disease (CHD) is one of the leading causes of morbidity and the most common cause of death in older adults. Paradoxically, elderly patients tend to be systematically excluded from randomized-controlled cardiovascular trials, which complicates decision-making in this population. Management of CHD in the elderly is frequently more difficult in virtue of chronic comorbid conditions and aging-intrinsic dynamics. Despite these challenges, the number of elderly and very elderly patients undergoing percutaneous coronary interventions (PCI) is increasing. Elderly patients in many registries and large clinical series exhibit even a greater benefit from interventional procedures than younger patients, but they have a higher rate of overall complications. We present an overview of the current available evidence of PCI in older adults with stable and unstable CHD, including comparisons between drug-eluting and bare-metal stents, transfemoral and transradial access, and methods of revascularization. Adjuvant antiplatelet and antithrombotic therapies are also discussed.     

补肾活血中药对无排卵功血患者子宫内膜雌孕激素受体的影响

[目的]探讨中西药物治疗无排卵功能失调性子宫出血(功血)的机理。[方法]采用酶联免疫分析技术和 SP免疫组化半定量检测技术,对37例无排卵功血患者经补肾活血中药宫血饮(主要由补骨脂、川续断、山茱萸、蒲黄、三七、党参、生龙骨、生牡蛎、白花蛇舌草等组成)或西药黄体酮治疗前后进行血清雌、孕激素(E_2、P)及子宫内膜雌、孕激素受体(ER、PR)测定。[结果]无排卵功血患者血清E_2水平和子宫内膜ER、PR水平均较对照组高,且ER、PR含量依子宫内膜的增生程度和类型的不同呈现下降趋势,即单纯增殖症>复杂增生>增生期。经合成孕激素治疗后,血清E_2水平和子宫内膜ER、PR水平均降低。补肾活血中药宫血饮亦能降低ER、PR水平,但对血清E_2影响不大。【结论】中药与合成孕激素治疗无排卵功血的作用机理不同,它并非通过降低血清雌激素的水平而达到治疗目的,推测它可能是通过非甾体激素途径,启动了各方面的因素影响ER、PR的合成而发挥其治疗作用的。     

择时针刺治疗糖尿病的临床研究

本文将５０例非胰岛素依赖型糖尿病患者分为不择时针刺组、胰岛素分泌高峰时针刺组、胰岛素分泌低谷时针刺组和药物Ｄ８６０组，进行治疗比较研究。结果表明：胰岛素分泌高峰时针刺组治疗后的空腹血糖、餐后２小时血糖、２４小时尿糖定量、糖化血红蛋白均有明显改善（Ｐ＜０．０１），改善程度较不择时针刺组及胰岛素分泌低谷时针刺组为优（Ｐ＜０．０１，）与西药Ｄ８６０组疗效相近。     

宫腔镜子宫内膜切除术治疗功能失调性子宫出血的疗效

【目的】探讨宫腔镜子宫内膜切除术(TCRE)治疗功能失调性子宫出血(dysfunctional uterine bleeding,DUB)的疗效。【方法】选取80例 DUB 患者作为研究对象,根据患者治疗方式分为两组：观察组40例,采用宫腔镜子宫内膜切除手术;对照组40例,采用非手术治疗。比较两组患者的临床疗效,分析观察组预后影响因素。【结果】观察组有效率为92.50%(37/40),显著高于对照组75.00%(30/40),其差异有统计学意义(P <0.05)。观察组患者的年龄、子宫内膜厚度、宫腔深度和子宫腺肌病与患者的预后明显相关(P <0.05)。【结论】TCRE 治疗 DUB 的临床疗效满意,患者预后与患者的年龄、宫腔深度、子宫内膜厚度和子宫腺肌病相关。     

不同播种期阳春砂种子的发芽实验研究

[目的] 探索阳春砂种子发芽的动态变化规律,明确砂仁种子的适宜播种期及储存期.[方法] 采用室外盆播方式,以5 d为1个间隔进行16期播种,观察出苗状况,记录实验数据并计算发芽率及发芽势.[结果] 湿沙储藏的春砂仁种子从8月26日至10月20日经分期播种,其发芽率及发芽势从低至高呈曲线上升趋势,9月前播种者发芽势不明显,10月25日播种则发芽率明显下降,且发芽势不明显;经湿沙储藏的春砂仁种子适用期或储存期为2个月;种子越成熟发芽力越高.[结论] 湿沙储藏可延长砂仁种子的适用期限;8月下旬至10月中下旬之间砂仁适期迟播比早播的发芽率及发芽势高,但结合生产实践考虑,9月20目前是湿沙藏砂仁种子的适宜播种期.     

痔外剥内扎术后肛门疼痛时间分布特点的纵向研究

[目的]探讨混合痔外剥内扎术后肛门疼痛的时间分布特点.[方法]运用描述性研究的方法,采用视觉模拟评分法(VAS)和肢体活动评分法(BRS),对300例患者进行多时点、多因素观察术后肛门疼痛的变化,纵向探讨其时间分布特点.[结果]痔外剥内扎术后患者多在2～4h开始出现肛门疼痛,多数(89％)在术后6～10 h内处于疼痛的...     

Associations of Fertility and Pregnancy Outcomes with Leather Tannery Work in Mongolia

Abstract

To our knowledge, reproductive health effects among male leather tannery workers have not been previously investigated. Tannery work involves exposure to chromium, solvents, and other chemicals, which has been associated with adverse pregnancy and fertility outcomes in animals or humans in some studies. This study retrospectively investigates the association of male leather tannery work with preterm delivery, spontaneous abortion, time to pregnancy, and infertility by comparing tannery employees to other workers in Ulaanbaatar, Mongolia. Participants were randomly selected from current employee rosters at eight tanneries and two bread-making companies. The results of this research suggest that tannery work may be associated with reduced fertility in males. The study had limited statistical power, and some factors are likely to have biased findings toward the null hypothesis; other limitations and possible sources of undetermined bias give reason for cautious interpretation. Additional studies should be conducted to further examine fertility among tannery workers.