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Selected AbstractsTHE PEST STATUS OF BEMISIA TABACI IN CHINA AND NON-CHEMICAL CONTROL STRATEGIES,INSECT SCIENCE, Issue 3 2001REN Shun-xiang AbstractBemisia tabaci (Gennadius) has been considered as a serious pest in all of tropical, subtropical and temperate regions of the world. B. tabaci first recorded as early as in 1940s in China and has been reported as a pest of various crops in 22 provinces or cities. But only recently it has become a severe problem for vegetable and ornamental crops in Guangdong and Beijing. In China B. tabaci is known to transmit at least 5 plant viruses, including tomato yellow leaf curl virus (TYLCV), tomato leaf curl virus (TomLCV), squash leaf curl virus (SqLCV-C). So far, approximately 18 parasitoids, 17 predators and 1 pathogenic fungus were recorded in China. This paper presents an overview of B. tabaci as a pest and virus vector in China, with special attention given to non-chemical control strategies. [source] An efficient method for combining adaptive echo and noise canceller in hands-free systemsINTERNATIONAL JOURNAL OF ADAPTIVE CONTROL AND SIGNAL PROCESSING, Issue 3 2009Jafar Ramadhan Mohammed Abstract Acoustic interferences severely degrade the quality and the intelligibility of the desired speech signal, thus posing a severe problem for many speech applications. Several acoustic echo cancellation (AEC) techniques have been proposed with a view to solving this problem. There are, however, few reports of AEC methods working under real noisy conditions. In this paper, we investigate the maximum positive synergies of the combination of acoustic echo canceller with a new adaptive beamformer. The proposed system achieves both the AEC and noise reduction of speech in an actual environment with real noise sources. Since the AEC is located behind the fixed beamformer of the new adaptive beamformer only one AEC is required for an arbitrary number of array elements, and the AEC does not feel any repercussions from the new adaptive beamformer. The proposed system was implemented in a real environment using National Instruments NI-PXI-1042Q controller system and data acquisition card PXI-4472. Experimental results show that the proposed system has successfully improved the performance of hands-free systems. Copyright © 2008 John Wiley & Sons, Ltd. [source] The new adhesion prophylaxis membrane A-part®,From in vitro testing to first in vivo resultsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2009Bernd Martin Jaenigen Abstract Introduction: Formation of postoperative intra-abdominal adhesions is a severe problem in surgery. Apart from standard surgical procedures, a variety of different substances is available to prevent adhesions, but no universal method has been developed so far. A membrane consisting of polyvinyl alcohol (PVA) and carboxymethylcellulose (CMC) has been demonstrated to be antiadhesive. Here, the in vitro testing and first in vivo results in a rabbit sidewall model are reported. Materials and Methods: A-part® membrane contains a PVA/CMC mixture in a thickness of 40 ,m. The composition, dissolution, tensile strength, and elasticity were examined to characterize the membrane in vitro. Experiments in vivo were carried out using a ,rabbit sidewall model' in which a standardized peritoneal trauma was covered with a 5 × 6 cm A-part® membrane. Adhesion formation in A-part®-treated animals was compared with that in Adept® (15 mL/kg body weight) and untreated controls. Results: An 80/20 PVA/CMC mixture forms a stable, elastic, transparent membrane, which can easily be placed intraoperatively. The dissolution shows a half-life of about 2 weeks [day 15: (45.1 ± 4.9)% SD], which affords good adhesion protection during the initial critical phase of adhesion formation. In wet conditions, the membrane follows abdominal movements without tearing (tensile strength 5.0 ± 4.2 N/cm SD; elasticity 29.5%). In a rabbit sidewall model, A-part® membrane significantly reduced adhesion development by (83.1 ± 31.5)% SD compared with the control and the Adept group (p < 0.001). Conclusion: The properties of the A-part® membrane suggest that it may be useful as an antiadhesive in surgery. A-part® is effective in invivo testing as determined in a rabbit sidewall model. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2009 [source] Conformational search of peptides and proteins: Monte Carlo minimization with an adaptive bias method applied to the heptapeptide deltorphinJOURNAL OF COMPUTATIONAL CHEMISTRY, Issue 4 2004S. Banu Ozkan Abstract The energy function of a protein consists of a tremendous number of minima. Locating the global energy minimum (GEM) structure, which corresponds approximately to the native structure, is a severe problem in global optimization. Recently we have proposed a conformational search technique based on the Monte Carlo minimization (MCM) method of Li and Scheraga, where trial dihedral angles are not selected at random within the range [,180°,180°] (as with MCM) but with biased probabilities depending on the increased structure-energy correlations as the GEM is approached during the search. This method, called the Monte Carlo minimization with an adaptive bias (MCMAB), was applied initially to the pentapeptide Leu-enkephalin. Here we study its properties further by applying it to the larger peptide with bulky side chains, deltorphin (H-Tyr-D-Met-Phe-His-Leu-Met-Asp-NH2). We find that on average the number of energy minimizations required by MCMAB to locate the GEM for the first time is smaller by a factor of approximately three than the number required by MCM,in accord with results obtained for Leu-enkephalin. © 2004 Wiley Periodicals, Inc. J Comput Chem 25: 565,572, 2004 [source] Bullying and victimisation in Scottish secondary schools: Same or separate entities?AGGRESSIVE BEHAVIOR, Issue 1 2002A. Karatzias Abstract Previous research has suggested that bullying is an increasingly severe problem in schools. Such research has approached the phenomenon from two different angles. Earlier research has treated bullying and victimisation as separate entities. However, current research suggests that bullies and victims engage in a special dynamic and interactive relationship, thereby providing the need for studying any similarities and differences between bullies and victims in relation to various factors. The present research has approached bullying and victimisation in both ways. First, we studied differences between bullies, victims, and those not involved in relation to various demographic, school, well-being, and personality factors to identify factors that separate these three groups. In addition, we studied differences between those involved in bullying/victimisation (one group) and those never involved in relation to the same aforementioned factors to highlight aspects of the development of their special relationship (i.e., common factors). Prevalence rates and types of bullying/victimisation experienced/expressed in Scottish schools were also investigated. It was found that bullying and victimisation, when treated as separate entities, differed in relation to peer self-esteem, with bullies reporting higher levels of peer self-esteem than victims. When bullies and victims were treated as one group (involved), they were found to differ from the noninvolved group in relation to various factors, including school, well-being, and personality factors. The involved group was found to be disadvantaged in relation to all measures used. However, overall results indicated that from all these factors the best predictors of overall involvement as bully, victim, or bully-victim were Quality of School Life and school stress. The present results support the notion that bullying and victimisation could be treated, by future research, as both separate and/or interactive entities. This is so because bullying and victimisation were found to differ in relation to one personality factor, that is, peer self-esteem. However, Quality of School Life and school stress, both school factors, were found to be associated with the phenomenon as a whole. Results are discussed in relation to future development of antibullying policy in Scottish schools.Aggr. Behav. 28:45,61, 2002. © 2002 Wiley-Liss, Inc. [source] Design of mixed conducting ceramic membranes/reactors for the partial oxidation of methane to syngasAICHE JOURNAL, Issue 10 2009Xiaoyao Tan Abstract The performance of mixed conducting ceramic membrane reactors for the partial oxidation of methane (POM) to syngas has been analyzed through a two-dimensional mathematical model, in which the material balance, the heat balance and the momentum balance for both the shell and the tube phase are taken into account. The modeling results indicate that the membrane reactors have many advantages over the conventional fixed bed reactors such as the higher CO selectivity and yield, the lower heating point and the lower pressure drop as well. When the methane feed is converted completely into product in the membrane reactors, temperature flying can take place, which may be restrained by increasing the feed flow rate or by lowering the operation temperature. The reaction capacity of the membrane reactor is mainly determined by the oxygen permeation rate rather than by the POM reaction rate on the catalyst. In order to improve the membrane reactor performance, reduction of mass transfer resistance in the catalyst bed is necessary. Using the smaller membrane tubes is an effective way to achieve a higher reaction capacity, but the pressure drop is a severe problem to be faced. The methane feed velocity for the operation of mixed conducting membrane reactors should be carefully regulated so as to obtain the maximum syngas yield, which can be estimated from their oxygen permeability. The mathematical model and the kinetic parameters have been validated by comparing modeling results with the experimental data for the La0.6Sr0.4Co0.2Fe0.8O3-, (LSCF) membrane reactor. © 2009 American Institute of Chemical Engineers AIChE J, 2009 [source] Dentists' perceptions of dentine hypersensitivity and knowledge of its treatmentJOURNAL OF ORAL REHABILITATION, Issue 3 2002D. G. Gillam The aim of the present investigation was to determine by questionnaire, UK dentists' perception of Dentine Hypersensitivity (DH) and knowledge of its treatment. A total of 403 questionnaires were sent to a selected group of UK dentists who had either inquired about further postgraduate education or had attended a course at the Eastman Dental Institute/Hospital. A total of 181 of 403 dentists (44·9%) (118M; 36F, 17 no response, mean age 38·2 years [s.d. 8·97]) returned the questionnaire. About 92·8% (n=168) of responding dentists claimed to see patients with DH in their practice. According to the dentists' replies at least one of four of their patients suffered from the complaint. About 71·8% (n=130) of dentists reported that DH was a severe problem in at least 10% of their patients and that pain from DH lasted no more than 4 weeks. Most of responding dentists claimed to be asked about DH by their patients and stated that they offered advice or treatment to their patients. Nearly 87·3% (n=158) of responding dentists provided a wide range of treatment options/advice which included both In-office and over-the-counter (OTC) products. Popular responses included desensitizing pastes/gels, Topical F, varnishes and toothpastes/rinses/gels, advice on atraumatic tooth brushing, dentine bonding agents (DBA), glass,ionomer cements (GIC) and other unspecified restorations. Of the various In-office treatments Duraphat was the most cited choice of varnish/primer options. Sensodyne toothpaste was the most popular of the specified OTC products. Most dentists appeared to understand the aetiological features associated with DH and provided a wide range of factors including the effects of incorrect tooth brushing, dietary acids as well as the possible influence on non-dental topics such as stress. Most responding dentists believed that their advice on DH was generally effective although they did highlight that certain aspects on the condition were lacking such as appropriate scientific information including the prevention of DH and its treatment. The results from the present study highlight several discrepancies in the perception and knowledge of the treatment of DH between dentists and their patients. The results from this study are, however, reasonably consistent with those previously reported by Dutch investigators. The results from this study also highlighted a need for guidelines on the aetiology, prevention and treatment of DH for both dentists and their patients. The reported average frequency and duration of discomfort from DH by the responding dentists appeared to be consistent with the available literature. [source] Recent advances in extending the shelf life of fresh Agaricus mushrooms: a reviewJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 9 2010Preeti Singh Abstract Postharvest browning of Agaricus mushrooms is a severe problem that reduces the shelf life of harvested mushrooms because of their continued respiration and biochemical activity. There are no simple answers and no single treatment is known to limit overall quality deterioration. However, there are several strategies that are being implemented in order to reduce the rate of respiration for mushrooms. Packaging technology is the common denominator that allows us to implement these strategies and thus is key to quality preservation. In this review, first, the major factors involved in postharvest quality deterioration are discussed and then technological advances/methods used to counteract these hurdles are presented. Copyright © 2010 Society of Chemical Industry [source] Validation of a 7-point Global Overall Symptom scale to measure the severity of dyspepsia symptoms in clinical trialsALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2006S. J. O. VELDHUYZEN VAN ZANTEN Summary Background, Currently there is no consensus on the optimal method to measure the severity of dyspepsia symptoms in clinical trials. Aim, To validate the 7-point Global Overall Symptom scale. Methods, The Global Overall Symptom scale uses a 7-point Likert scale ranging from 1 = no problem to 7 = a very severe problem. Validation was performed in two randomized-controlled trials (n = 1121 and 512). Construct validity: Global Overall Symptom was compared with the Quality of Life in Reflux And Dyspepsia, Gastrointestinal Symptom Rating Scale, Reflux Disease Questionnaire and 10 specific symptoms using Spearman correlation coefficients. Test,retest reliability: The Intraclass Correlation Coefficient was calculated for patients with stable dyspepsia defined by no change in Overall Treatment Effect score over two visits. Responsiveness: effect size and standardized response mean were also calculated. Results, Construct validity: Change in Global Overall Symptom score correlated significantly with Quality of Life for Reflux And Dyspepsia, Gastrointestinal Symptom Rating Scale, Reflux Disease Questionnaire and specific symptoms (all P < 0.0002). Reliability: The Intraclass Correlation Coefficient was 0.62 (n = 205) and 0.42 (n = 270). Responsiveness: There was a positive correlation between change in Global Overall Symptom and change in symptom severity. The effect size and standardized response mean were 1.1 and 2.1, respectively. Conclusion, The Global Overall Symptom scale is a simple, valid outcome measure for dyspepsia treatment trials. [source] Nitrogen in diamond-free ureilite Allan Hills 78019: Clues to the origin of diamond in ureilitesMETEORITICS & PLANETARY SCIENCE, Issue 8 2002V. K. Rai A small amount of amorphous carbon combusting at ,500 °C carries most of the noble gases, while the major carbon phase consisting of large crystals of graphite combusts at ,800 °C, and is almost noble-gas free. Nitrogen on the other hand is present in both amorphous carbon and graphite, with different ,15N signatures of ,21%o and +19%o, respectively, distinctly different from the very light nitrogen (about ,100%o) of ureilite diamond. Amorphous carbon in ALH 78019 behaves similar to phase Q of chondrites with respect to noble gas release pattern, behavior towards oxidizing acids as well as nitrogen isotopic composition. In situ conversion of amorphous carbon or graphite to diamond through shock would require an isotopic fractionation of 8 to 12% for nitrogen favoring the light isotope, an unlikely proposition, posing a severe problem for the widely accepted shock origin of ureilite diamond. [source] Hemispheric brain volume replacement with free latissimus dorsi flap as first step in skull reconstructionMICROSURGERY, Issue 4 2005Anton H. Schwabegger M.D. Large skull defects lead to progressive depression deformities, with resulting neurological deficits. Thus, cranioplasty with various materials is considered the first choice in therapy to restore cerebral function. A 31-year-old female presented with a massive left-sided hemispheric substance defect involving bone and brain tissue. Computed tomography showed a substantial convex defect involving the absence of calvarial bone as well as more than half of the left hemisphere of the brain, with a profound midline shift and a compression of the ventricular system. There was a severe problem due to multiple deep-skin ulcerations at the depression margin, prone to skin perforation with a probability of intracranial infection. In a first step, a free myocutaneous latissimus dorsi flap was transplanted for volume replacement of the hemispheric brain defect, and 4 months later, artificial bone substitute was implanted in order to prevent progressive vault depression deformity. Healing was uneventful, and the patient showed definite neurological improvement postoperatively. Free tissue transfer can be a valuable option in addition to cranioplasty in the treatment of large bony defects of the skull. Besides providing stable coverage for the reconstructed bone or its substitute, it can also serve as a volume replacement. © 2005 Wiley-Liss, Inc. Microsurgery 25:325,328, 2005. [source] Macroeconomic Control in the Transforming Chinese Economy: An Analysis of the Long-Run EffectPACIFIC ECONOMIC REVIEW, Issue 1 2001Michael K. Y. Fung This paper analyzes the issue of macroeconomic control in the Chinese economy where there is a dual structure (consisting of a state sector and a non-state sector) and the financial sector is still under tight control by the government. Given the dual structure and financial repression, when inflation is a severe problem, the authors investigate whether it is possible for the government to bring inflation under control without hampering long-term economic growth performance. The investigation is conducted within the context of an endogenous growth model that incorporates the two major institutional features of the transforming Chinese economy. The paper evaluates the long-run effects of changes in government monetary and fiscal policies on the major macroeconomic aggregates. The analysis suggests that increasing in the interest rate on government bonds will reduce inflation without affecting the growth rate of output; while increasing the nominal interest rate on bank deposits will exert a stagflationary effect on the economy: raising the inflation rate but reducing the growth rate of output. [source] Lymphoid bronchiolitis presenting at birth in an immunocompetent child: Chronic interstitial lung disease of unknown aetiologyPEDIATRIC PULMONOLOGY, Issue 6 2009Malcolm Brodlie MB ChB Abstract A female infant presented at birth with respiratory distress, which was subsequently shown to be secondary to lymphoid bronchiolitis, an exceptionally rare condition in childhood. Over the following 13 years there has been a slow progressive deterioration in her respiratory status with forced expiratory volume in 1 sec currently 40% predicted. Tests for connective tissue disease, infection, or immunodeficiency have all been negative and in the absence of any other explanation we postulate that this severe problem may have occurred as a consequence of an unrecognized intrauterine infection. Pediatr Pulmonol. 2009; 44:622,624. © 2009 Wiley-Liss, Inc. [source] Reactivation: A severe problem in familial hemophagocytic lymphohistiocytosisPEDIATRICS INTERNATIONAL, Issue 1 2002Omer Devecioglu No abstract is available for this article. [source] Drug resistance and genotypic analysis of Mycobacterium tuberculosis strains from Thai tuberculosis patientsAPMIS, Issue 4 2009WATTANA CHEUNOY The aim of this study was the molecular characterization of primary drug-resistant Mycobacterium tuberculosis strains in Thailand. We examined a group of M. tuberculosis isolates from newly registered tuberculosis (TB) cases, collected at the largest university hospital, the Siriraj Hospital, in Thailand. Of 76 selected drug-resistant M. tuberculosis strains recovered from previously untreated pulmonary TB patients whose sputum samples were sent to this hospital, 29 (38%) were single-drug resistant, 26 (34%) multidrug resistant and two (2.6%) extensively drug resistant. Fifty (66%) strains belonged to Beijing genotype. The study demonstrate a severe problem of drug resistance among recently detected TB patients, and two large clusters of genetically similar strains indicated ongoing transmission of drug-resistant TB. [source] Combining land cover mapping of coastal dunes with vegetation analysisAPPLIED VEGETATION SCIENCE, Issue 2 2005A. Acosta Abstract Question: Coastal dune systems are characterized by a natural mosaic that promotes species diversity. This heterogeneity often represents a severe problem for traditional mapping or ground survey techniques. The work presented here proposes to apply a very detailed CORINE land cover map as baseline information for plant community sampling and analysis in a coastal dune landscape. Location: Molise coast, Central Italy. Method: We analysed through an error matrix the coherence between land cover classes and vegetation types identified through a field survey. The CORINE land cover map (scale 1: 5000) of the Molise coast was used with the CORINE legend expanded to a fourth level of detail for natural and semi-natural areas. Vegetation data were collected following a random stratified sampling design using the CORINE land cover classes as strata. An error matrix was used to compare, on a category-by-category basis, the relationship between vegetation types (obtained by cluster analyses of sampling plots) and land cover classes of the same area. Results: The coincidence between both classification approaches is quite good. Only one land cover class shows a very weak agreement with its corresponding vegetation type; this result was interpreted as being related to human disturbance. Conclusions: Since it is based on a standard land cover classification, the proposal has a potential for application to most European coastal systems. This method could represent a first step in the environmental planning of coastal systems. [source] HI , the window to the early universe in X-raysASTRONOMISCHE NACHRICHTEN, Issue 1-2 2003J. Kerp Abstract A detailed understanding of the soft X-ray background (SXRB) is of high importance for the next generation of X-ray telescopes, which will focus on early universe objects. Because of their high redshift the characteristic X-ray emission of the early universe objects will be observable in the soft X-ray energy domain below E = 1 keV. In this energy regime the photoelectric absorption of the galactic interstellar medium attenuates the X-ray emission most strongly. The confusion with the spatially highly variable galactic soft X-ray emission might be an additional severe problem to disentangle the emission of the early universe object and the SXRB. We present the cross correlation of the Leiden/Dwingeloo HI 21-cm line survey with the ROSAT all-sky survey. The analyses disclose the existence of a single temperature plasma within the Milky Way halo. The strength of the photoelectric absorption is quantitatively traced by the distribution of the HI emission across the whole sky. Both findings in combination open the window to the highly redshift early universe objects. [source] Synthesis of Novel gluco - and galacto -Functionalized Platinum Complexes,EUROPEAN JOURNAL OF ORGANIC CHEMISTRY, Issue 28 2009Janina Möker Abstract Cisplatin, carboplatin, oxaliplatin and further derivatives are worldwide established cytostatics for the treatment of a vast range of tumours. These drugs showed extraordinary success; however, side effects and primary or developed secondary resistance of tumour cells represent severe problems, which prompt the development of novel functionalized platinum complexes. Selectively protected monohydroxy derivatives of glucose and galactose could be etherified by ,-halo ethers. Further, Finkelstein reaction and malonate synthesis gave precursor glycoconjugates which were easily transformed into their (diammine)platinum complexes. First tests with different tumour cell lines show biological activity of the gluco -functionalized platinum complex.(© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2009) [source] Regulation of natural genetic transformation and acquisition of transforming DNA in Streptococcus pneumoniaeFEMS MICROBIOLOGY REVIEWS, Issue 3 2009Ola Johnsborg Abstract The ability of pneumococci to take up naked DNA from the environment and permanently incorporate the DNA into their genome by recombination has been exploited as a valuable research tool for 80 years. From being viewed as a marginal phenomenon, it has become increasingly clear that horizontal gene transfer by natural transformation is a powerful mechanism for generating genetic diversity, and that it has the potential to cause severe problems for future treatment of pneumococcal disease. This process constitutes a highly efficient mechanism for spreading ,-lactam resistance determinants between streptococcal strains and species, and also threatens to undermine the effect of pneumococcal vaccines. Fortunately, great progress has been made during recent decades to elucidate the mechanism behind natural transformation at a molecular level. Increased insight into these matters will be important for future development of therapeutic strategies and countermeasures aimed at reducing the spread of hazardous traits. In this review, we focus on recent developments in our understanding of competence regulation, DNA acquisition and the role of natural transformation in the dissemination of virulence and ,-lactam resistance determinants. [source] Public perceptions about low back pain and its management: a gap between expectations and reality?HEALTH EXPECTATIONS, Issue 3 2000Jennifer A. Klaber Moffett PhD MSc MCSP Objective To compare public perceptions and patient perceptions about back pain and its management with current clinical guidelines. Design A survey using a quota sampling technique. Setting On-the-street in South Derbyshire in the UK. Subjects 507 members of the general population aged between 20 and 60 years, including a representative subsample of 40% who had experienced back pain in the previous year. Survey To test knowledge and perceptions of back pain and its best management using statements based on The Back Book which was produced in conjunction with the Royal College of General Practitioners and based on best available evidence. In addition expectations of back pain management and outcome were investigated. Results Forty percent of this sample had experienced back pain during the previous year, more than half of whom had consulted their GP. More than half believed the spine is one of the strongest part of the body, but nearly two thirds incorrectly believed that back pain is often due to a slipped disc or trapped nerve. Two thirds expected a GP to be able to tell them exactly what was wrong with their back, although slightly fewer among those who had consulted. Most expected to have an X-ray, especially if they had consulted. Most recognised that the most important thing a GP can do is offer reassurance and advice. The responses were not related to age, gender or social class. Those who had consulted appeared to have slightly more misconceptions: this could be partly due to people with more severe problems or more misconceptions being more likely to consult, but also suggests either that GPs are still giving inaccurate information or at least failing to correct these misconceptions. Conclusions The problem of managing back pain might be reduced by closing the gap between the public's expectations and what is recommended in the guidelines through the promotion of appropriate health education messages. Further professional education of GPs also appears to be needed to update them in the most effective approach to managing back pain. [source] Predicting developmental deficiencies at the age of four based on data from the first seven months of life,INFANT MENTAL HEALTH JOURNAL, Issue 6 2008Anne Margrethe Rostad The study examines very young children with the aim of identifying precursors of developmental problems during the first 7 months of age. Information from screening and observations in the birth clinic, in the first level of health care, and from parents was collected on five different occasions. The information that was included concerning the child and family was defined as either optimal or nonoptimal. At the age of 4 years, a clinical group was identified (11.1% of the total population). Logistic regression analyses were performed to detect risk factors. Twenty-one precursors were used to create a screening questionnaire that provided useful information (sensitivity = 56.1%, specificity = 98.8%) for predicting developmental problems of the children. The contribution of sociodemographic data was significant; medical information was less significant. The highest prediction rate surprisingly was found in the moderate clinical subgroup (62.1%), compared to the group with more severe problems that had a slightly lower rate (46.7%). The conclusion of the study is that it is possible to detect infants in need of early intervention using a continuous process of observation and screening. [source] PAQM: an adaptive and proactive queue management for end-to-end TCP congestion controlINTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 8 2004Seungwan RyuArticle first published online: 2 SEP 200 Abstract Two functions, the congestion indicator (i.e. how to detect congestion) and the congestion control function (i.e. how to avoid and control congestion), are used at a router to support end-to-end congestion control in the Internet. Random early detection (RED) (IEEE/ACM Trans. Networking 1993; 1(4):397,413) enhanced the two functions by introducing queue length averaging and probabilistic early packet dropping. In particular, RED uses an exponentially weighted moving average (EWMA) queue length not only to detect incipient congestion but also to smooth the bursty incoming traffic and its resulting transient congestion. Following RED, many active queue management (AQM)-based extensions have been proposed. However, many AQM proposals have shown severe problems with detection and control of the incipient congestion adaptively to the dynamically changing network situations. In this paper, we introduce and analyse a feedback control model of TCP/AQM dynamics. Then, we propose the Pro-active Queue Management (PAQM) mechanism, which is able to provide proactive congestion avoidance and control using an adaptive congestion indicator and a control function under a wide range of traffic environments. The PAQM stabilizes the queue length around the desired level while giving smooth and low packet loss rates and high network resource utilization. Copyright © 2004 John Wiley & Sons, Ltd. [source] Multilevel investigation of variation in HoNOS ratings by mental health professionals: a naturalistic study of consecutive referralsINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2004R. Ecob Episodes of mental healthcare in specialist psychiatric services often begin with the assessment of clinical and psychosocial needs of patients by healthcare professionals. Particularly for patients with complex needs or severe problems, ratings of clinical and social functioning at the start of each episode of care may serve as a baseline against which subsequent measures can be compared. Currently, little is known about service variations in such assessments on referrals from primary care. We set out to quantify variability in initial assessments performed by healthcare professionals in three CMHTs in Bristol (UK) using the Health of the Nation Outcome Scales (HoNOS). We tested the hypothesis that variations in HoNOS total and sub-scale scores are related to referral source (general practices), healthcare assessor (in CMHTs) and the assessor's professional group. Statistical analysis was performed using multilevel variance components models with cross-classified random effects. We found that variation due to assessor substantially exceeded that due to referral source (general practices). Furthermore, patient variance differed by assessor profession for the HoNOS , Impairment scores. Assessor variance differed by assessor profession for the HoNOS , Social scores. As HoNOS total and subscale scores show much larger variation by assessor than by referral source, investigations of HoNOS scores must take assessors into account. Services should implement and evaluate interdisciplinary training to improve consistency in use of rating thresholds; such initiatives could be evaluated using these extensions of multilevel models. Future research should aim to integrate routine diagnostic data with continuous outcomes to address selection effects (of patients to assessors) better. Copyright © 2004 Whurr Publishers Ltd. [source] Democratic demand for a social Europe?INTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 2 2005Preferences of the European citizenry Within the literature on European integration there is a widespread assumption that Europe is in need of intensified and more effective supranational social policy cooperation. However, on the political level it is doubtful whether such measures are welcomed by the national electorates. This article addresses this issue empirically by asking whether there is public demand for promoting greater European welfare policy cooperation and what are the determinants of such a demand. The data source used is the Eurobarometer survey 2000. A number of hypotheses dealing with socio-structural differences, the effects of welfare regime types, the subjective evaluation of the integration process and the role of identity will be scrutinised. Overall, the results indicate that at the attitudinal ,grass root' level there is no unequivocal support for a European welfare responsibility and that some fundamental cleavages are present. It is the regional and cultural aspects, especially, which turn out to be having an effect and to be influencing future political conflicts. A common European welfare arrangement, therefore, cannot be regarded as a solution to the problems the European Union is facing; rather it will raise new and severe problems of finding social and political support. [source] Variability of tilapias (Oreochromis spp.) introduced in Mexico: morphometric, meristic and genetic charactersJOURNAL OF APPLIED ICHTHYOLOGY, Issue 1 2004I. D. L. A. Barriga-Sosa Summary In Mexico, the tilapia Oreochromis provides one of the most important sources of animal protein and income in a wide variety of communities throughout the country, however, their culture and production face severe problems because of lack of management information. Evaluated in the present study is the degree of morphological, meristic and allozyme variation of two tilapia strains, two species and one hybrid from two important reservoirs in Mexico, two tilapia fry production farms (TFPF) and an experimental production system (EPS), to diagnose the actual status and degree of variation among them. Twenty-two presumptive loci were utilized to determine the genetic variation, structuring and distances among samples. Multivariate analyses of 11 meristic and 33 morphometric characters were also evaluated, including the distance from the end of the mouth opening to the most anterior dorsal fin (0.9894), distance from the anal fin base to the anterior part of the caudal fin (0.9845) and the base length of the dorsal fin (0.9839) which contributed to the separation of groups. The canonical discriminant functions for the morphometric and meristic variables show that the correct classification of the organisms in percentages and in the sites of origin was on average 72%. The tilapia from the reservoirs and the experimental production system had higher genetic variations than tilapia from the fry production farms (average He 0.310, 0.062, 0.151 for Metztitlan, Infiernillo and EPS, respectively, vs 0.024 and 0.000 for Los Amates and Zacatepec, respectively). The genetic data indicate that fishes of the TFPF should be monitored closely, as they are the main source of dispersion to the reservoirs. Present results show that these data could be a fast and reliable aid to the fisheries and management of tilapia in Mexico. [source] Some soft tissue characteristics at implant abutments with different surface topographyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2003A study in humans Abstract Background: If an implant with a rough surface is exposed to the oral cavity, it may accumulate greater amounts of plaque than a smooth surface, which may lead to severe problems with mucositis and peri-implantitis. The purpose of the present paper was to investigate the early inflammatory response to mucosa-penetrating abutments prepared with varying surface roughness. Methods: Nine patients had all five of their original abutments exchanged to test abutments for a 4-week period. The test abutments were prepared with five different roughnesses. The surface roughness was measured with an optical profilometer. At the end of the test period, clinical evaluation was performed; the health of the surrounding mucosa, the amount of accumulated plaque and marginal bleeding were registered. One biopsy was taken from each test abutment. Qualitative and quantitative histological evaluations were performed. Results: There was a statistically significant difference between patients regarding the amount of accumulated plaque on the abutment surfaces and inflammatory cells, but no difference between the surface modifications in relation to plaque accumulation or number of inflammatory cells. Conclusion: No relation was found between inflammatory response and abutment surface roughness after an evaluation time of 4 weeks in a human test model. Zusammenfassung Hintergrund: Wenn ein Implantat mit einer rauhen Oberfläche der Mundhöhle ausgesetzt wird, kann es zu stärkerer Plaqueakkumulation kommen als bei glatten Oberflächen, was zu ernsthaften Problemen mit Mukositis und Periimplantitis führen kann. Zielsetzung: Untersuchung der frühen Entzündungsreaktion auf durch die Schleimhaut tretende Implantatpfeiler mit unterschiedlicher Oberflächenrauhigkeit. Methoden: Bei jedem von 9 Patienten wurden alle 5 ursprünglichen Implantatpfeiler für einen Zeitraum von 4 Wochen gegen Testpfeiler ausgetauscht. Die Testpfeiler waren jeweils mit unterschiedlichen Oberflächenrauhigkeiten präpariert. Die Rauhigkeiten waren mit einem Profilometer gemessen worden. Am Ende des Untersuchungszeitraumes wurden klinische Parameter bestimmt: der Zustand der periimplantären Mukosa, die Menge der akkumulierten Plaque und marginales Bluten. An jedem Pfeiler wurde eine Biopsie entnommen, die jeweils qualitativ und quantitativ histologisch ausgewertet wurde. Ergebnisse: Es bestanden statistisch signifikante interindividuelle Unterschiede zwischen den Patienten hinsichtlich abgelagerter Plaque und Zahl der Entzündungszellen an den Implantatpfeilern, aber keine diesbezüglichen intraindividuellen Unterschiede zwischen den verschiedenen Oberflächenrauhigkeiten. Schlussfolgerung: In einem menschlichen Versuchsmodell wurden über einen Zeitraum von 4 Wochen keine Beziehungen zwischen Entzündungsreaktion und Implantatpfeileroberflächenrauhigkeit beobachtet. Résumé Origine: Lorsqu'un implant à surface rugueuse est exposé dans la cavité buccale, il peut accumuler davantage de plaque qu'une surface lisse, ce qui peut conduire à des problèmes graves associés à une mucite ou une péri-implantite. Le but de cette étude était d'examiner la réponse inflammatoire précoce aux implants pénétrant la muqueuse et ayant une rugosité de surface variable. Méthodes: Les cinq implants d'origine de chacun des neuf patients ont été remplacés par des implants expérimentaux pour une période de quatre semaines. Ces implants expérimentaux ont été conçus avec cinq rugosités différentes. La rugosité de surface a été mesurée à l'aide d'un profilomètre optique. A l'issue de la période expérimentale, une évaluation clinique a été réalisée: l'état de la muqueuse environnante, la quantité de plaque accumulée et le saignement marginal ont été relevés. Une biopsie a été prélevée sur chaque implant expérimental et des évaluations histologiques qualitatives et quantitatives ont été faites. Résultats: Il y avait une différence statistiquement significative entre les patients en ce qui concerne la quantité de plaque accumulée à la surface des implants et les cellules inflammatoires, mais aucune différence entre les modifications de surface en rapport avec l'accumulation de plaque ou le nombre de cellules inflammatoires. Conclusion: Aucune relation n'a étéétablie entre la réponse inflammatoire et la rugosité de surface des implants au bout de quatre semaines d'évaluation dans un modèle expérimental humain. Mots clés: Pilier d'implant; réponse des tissus mous; étude clinique; histologie. [source] Alternatives for Reducing the Environmental Impact of the Main Residue From a Desalination PlantJOURNAL OF INDUSTRIAL ECOLOGY, Issue 3 2010Montse Meneses Summary One of the most important problems today is the scarcity of fresh water safe enough for human, industrial, and agricultural use. Desalination is an alternative source of fresh water supply in areas with severe problems of water availability. Desalination plants generate a huge amount of brine as the main residual from the plant (about 55% of collected seawater). Because of that, it is important to determine the best environmental option for the brine disposal. This article makes a global environmental analysis, under Spanish conditions, of a desalination plant and an environmental assessment of different final brine disposals, representing a range of the most common alternatives: direct disposal, wastewater treatment plant (WWTP) outflow dilution, and dilution with seawater. The environmental profile of the plant operation and a comparison of the brine final disposal alternatives were established by means of the life cycle assessment (LCA) methodology. From an analysis of the whole plant we observed that the highest environmental impact was caused by energy consumption, especially at the reverse osmosis stage, while the most relevant waste was brine. From an analysis of brine final disposal we have elaborated a comparison of the advantages and detriments of the three alternatives. As all of them might be suitable in different specific situations, the results might be useful in decisions about final brine disposal. [source] On the effectiveness of clone detection by string matchingJOURNAL OF SOFTWARE MAINTENANCE AND EVOLUTION: RESEARCH AND PRACTICE, Issue 1 2006Stéphane Ducasse Abstract Although duplicated code is known to pose severe problems for software maintenance, it is difficult to identify in large systems. Many different techniques have been developed to detect software clones, some of which are very sophisticated, but are also expensive to implement and adapt. Lightweight techniques based on simple string matching are easy to implement, but how effective are they? We present a simple string-based approach which we have successfully applied to a number of different languages such COBOL, JAVA, C++, PASCAL, PYTHON, SMALLTALK, C and PDP-11 ASSEMBLER. In each case the maximum time to adapt the approach to a new language was less than 45 minutes. In this paper we investigate a number of simple variants of string-based clone detection that normalize differences due to common editing operations, and assess the quality of clone detection for very different case studies. Our results confirm that this inexpensive clone detection technique generally achieves high recall and acceptable precision. Over-zealous normalization of the code before comparison, however, can result in an unacceptable numbers of false positives. Copyright © 2005 John Wiley & Sons, Ltd. [source] A Syntactic Bias in Scope Ambiguity Resolution in the Processing of English-French Cardinality Interrogatives: Evidence for Informational EncapsulationLANGUAGE LEARNING, Issue 1 2005Laurent Dekydtspotter This article presents a reading-time study of scope resolution in the interpretation of ambiguous cardinality interrogatives in English-French and in English and French native sentence processing. Participants were presented with a context, a self-paced segment-by-segment presentation of a cardinality interrogative, and a numerical answer that respondents either accepted or rejected. Very narrowly distributed and interpretation-dependent reading-time asymmetries arose in English-French processing and in French and English native processing. A syntactic account of scope resolution characterizes the reading-time asymmetries produced by English-French learners and differences between French and English native respondents. In contrast, a context-driven theory of scope resolution encounters many severe problems that render its plausibility exceedingly remote. [source] Proceedings of the 20th Annual Conference of the Japanese Association for Adolescent Psychotherapy, 16 November 2002, Tokyo, JapanPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2003Article first published online: 28 AUG 200 Inpatient treatment of obsessive,compulsive disorder in a child and adolescent psychiatry ward M. USAMI National Center of Neurology and Psychiatry, Kohnodai Hospital, Chiba, Japan This is a case report of a 13-year-old-boy (2nd grade in junior high school). His father had poor communication; his mother was a very fragile woman. The boy had been overprotected by his parents, as long as he responded to their expectations. He did not have any other siblings. He played well with his friends since he was young, and did not have problems until the 1st term (from April to July) of 1st grade in junior high school. However, in September he started to have difficulties going well with his friends, and going to school. He spent most of his time in his room, and began to repeat checking and hand-washing frequently. Even at midnight, he forced his mother to touch the shutter from outside of the house for many times. He also ritually repeated to touch his mother's body, after he licked his hands, for over an hour. He became violent, when his parents tried to stop him. In April, year X, his parents visited our hospital for the first time. From then, his mother could not tolerate her son's coerciveness any longer. His father explained to the boy that ,your mother has been hospitalized', and she started to live in the next room to the boy's without making any noise. After 3 months he noticed that his mother was not hospitalized, and he got very excited. He was admitted to our hospital with his family and relatives, in October, year X. At the initial stage of hospitalization he showed distrust and doubt towards the therapist and hospital. He had little communication with other boys and did not express his feelings. Therefore, there was a period of time where he seemed to wonder whether he could trust the treatment staff or not. During his interviews with his therapist he repeated only ,I'm okay' and did not show much emotional communication. For the boy, exposing himself was equivalent to showing his vulnerability and incompleteness. Therefore, the therapist considered that he was trying to denying his feelings to avoid this. The therapist set goals for considering his own feelings positively and expressing them appropriately. Also, the therapist carried out behavioral restrictions towards him. He hardly had any emotional communication with the staff, and his peer relationship in the ward was superficial. Therefore, he gradually had difficulty spending his time at the end of December On the following day in which he and the therapist decided to return to his house for the first time, he went out of the ward a few days before without permission. From thereon it was possible for him to share feelings such as hostility and aggression, dependence and kindness with the therapist. The therapist changed his role from an invasive one to a more protective one. Then, his unsociability gradually faded. He also developed good peer relationships with other boys in the ward and began to express himself feeling appropriately. He was also able to establish appropriate relations with his parents at home, and friends of his neighborhood began to have normal peer relationships again. During childhood and adolescence, boys with obsessive,compulsive disorder are known to have features such as poor insight and often involving their mothers. We would like to present this case, through our understanding of dynamic psychiatry throughout his hospitalization, and also on the other therapies that were performed. Psychotherapy with a graduate student that discontinued after only three sessions: Was it enough for this client? N. KATSUKI Sophia University, Tokyo, Japan Introduction: Before and after the psychotherapy, SWT was administrated in this case. Comparing these two drawings, the therapist was provided with some ideas of what kind of internal change had taken place inside this client. Referring to the changes observed, we would like to review the purposes and the ways of the psychotherapy, as well as the adequacy of the limited number of the sessions (vis-a-vis result attained.) Also we will discuss later if any other effective ways could be available within the capacities of the consulting system/the clinic in the university. Case: Ms. S Age 24 years. Problems/appeal: (i) awkwardness in the relationship with the laboratory colleagues; (ii) symptoms of sweating, vomiting and quivering; and (iii) anxiety regarding continuing study and job hunting. Diagnosis: > c/o PTSD. Psychotherapeutic setting: At the therapy room in the clinic, placed at the university, 50 min-session; once a week; paralleled with the medical treatment. Process: (1) Since she was expelled from the study team in the previous year, it has become extremely difficult for her to attend the laboratory (lab) due to the aforementioned symptoms. She had a feeling of being neglected by the others. When the therapist suggested that she compose her mental confusions in the past by attending the therapy room, she seemed to be looking forward to it, although she said that she could remember only a few. (2) She reported that she overdosed on sedatives, as she could not stop irritating. She was getting tough with her family, also she slashed the mattress of her bed with a knife for many times. She complained that people neither understood nor appreciated her properly. and she said that she wanted revenge on the leader of the lab by punishing him one way or other. (3) Looking back the previous session, she said ,I had been mentally mixed up at that time, but I feel that now I can handle myself, as I stopped the medication after consulting the psychiatrist. According to what she said, when she disclosed the occurrences in the lab to her mother, she felt to be understood properly by her mother and felt so relieved. and she also reported that she had been sewing up the mattress which she slashed before, without any reason. She added, " although I don't even know what it means, I feel that this work is so meaningful to me, somehow". Finally, she told that she had already made her mind to cope with the situation by herself from now on, although it might result in a flinch from the real solution. Situations being the above, the session was closed. Swt: By the remarkable changes observed between the two drawings, the meanings of this psychotherapy and its closure to the client would be contemplated. Question of how school counselors should deal with separation attendant on students' graduation: On a case in which the separation was not worked through C. ASAHARA Sophia University, Tokyo, Japan Although time limited relationship is one of the important characteristics in school counseling, the question of separation attendant on it has not been much discussed based on specific cases. This study focuses on the question of separation through looking at a particular case, in which the separation was not worked through, and halfway relationship continued even after the student's graduation and the counselor's resignation. I was a part time school counselor at a junior high school in Tokyo. The client was a 14-year-old female student, who could not go to her classroom, and spent a few hours in a sick bay when she came to school. She was in the final grade and there was only half a year left before graduation when we first met, and we started to see each other within a very loose structure. As her personality was hyper-vigilant and defensive, it took almost 2 months before I could feel that she was nearer. Her graduation was the first occasion of separation. On that occasion, I found that there had been a discrepancy between our expectations; while I took it for granted that our relationship would end with the graduation, she expected to see me even after she graduated, and she actually came up to see me once in a while during the next year. A year later, we faced another occasion of separation, that was my resignation. Although I worried about her, all I have done for her was to hand a leaflet of a counseling office, where I work as a part time counselor. Again I could not refer to her feelings or show any concrete directions such as making a fixed arrangement. After an occasional correspondence for the next 10 months (about 2 years after her graduation), she contacted me at the counseling office asking for a constant counseling. Why could I not deal with both occasions? and how did that affect the client thereafter? There were two occasions of separation. At the time of the client's graduation, I seemed to be enmeshed in the way of separation that is peculiar to the school setting. In general in therapeutic relationship, mourning work between counselor and client is regarded as being quite important. At school, however, separation attendant on graduation is usually taken for granted and mourning work for any personal relationship tends to be neglected. Graduation ceremony is a big event but it is not about mourning over one's personal relationships but separation from school. That may be why I did not appreciate how the client counted on our relationship. At the time of my resignation I was too worried about working through a change from very loose structure which is peculiar to the school setting to a usual therapeutic structure (fees are charged, and time, place are fixed). That is why I did nothing but give her a leaflet. In this way, we never talked about her complex feelings such as sadness or loneliness, which she was supposed to experience on separation. Looking at the aforementioned process from the client's viewpoint, it can be easily imagined that she could not accept the fact of separation just because she graduated. and later, she was forced to be in double-bind situation, in which she was accepted superficially (handed a leaflet), while no concrete possibility was proposed concerning our relationship (she could never see me unless she tries to contact me.) As a result, she was left alone and at a loss whether she could count on me or not. The halfway situation or her suspense was reflected in her letter, in which she appeared to be just chatting at first sight, but between the lines there was something more implying her sufferings. Above discussion suggests that in some case, we should not neglect the mourning work even in a school setting. To whom or how it is done is the next theme we should explore and discuss in the future. For now, we should at least be conscious about the question of separation in school setting. Study of the process of psychotherapy with intervals for months M. TERASHIMA Bunkyo Gakuin University, Tokyo, Japan This is a report on the process of psychotherapy of an adolescent girl who showed manic and depressive state. At the time of a depressed state, she could not go to a college and withdrew into home, and the severe regressive situation was shown. Her therapy began at the age of 20 and she wanted to know what her problem was. The process of treatment went on for 4 years but she stopped coming to sessions for several months because of failure of the therapist. She repeated the same thing twice. After going through these intervals the client began to remember and started to talk about her childhood , suffering abusive force from her father, with vivid impressions. They once were hard for her to accept, but she began to establish the consistent figure of herself from past to present. In this case, it could be thought that the intervals of the sessions had a certain role, with which the client controlled the structure of treatment, instead of an attack against the therapist. Her object relation, which is going to control an object offensively, was reflected in these phenomena. That is, it can be said that the ambivalence about dependency , difficult to depend but desirous of the object , was expressed. Discontinuation of the sessions was the product of the compromise formation brought about the ambivalence of the client, and while continuing to receive this ambivalence in the treatment, the client started to realize discontinuance of her memories and then advanced integration of her self-image. For the young client with conflict to dependence such as her, an interval does not destroy the process of treatment but in some cases it could be considered as a therapeutic element. In the intervals the client could assimilate the matter by herself, that acquired by the sessions. Psychotherapy for a schizoid woman who presented eccentric speech and behaviour M. OGASAWARA Osaka University Graduate School of Medicine, Osaka, Japan Case presentation: A case of a 27-year-old woman at the beginning of therapy. Life history: She had been having a wish for death since she was in kindergarten and she had been feeling strong resistance to do the same as others after school attendance. She had a history of ablutomania from the age of 10,15, but the symptom disappeared naturally. and she said that she had been eliminated from groups that she tried to enter. After graduating a junior college, she changed jobs several times without getting a full-time position. Present history: Scolded by her boy friend for her coming home too late one day, she showed confusion such as excitement, self-injury or terror. She consulted a psychiatrist in a certain general hospital, but she presented there eccentric behaviours such as tense facial expression, stiffness of her whole body, or involuntary movement of limbs. and because she felt on bad terms with the psychiatrist and she had come to cause convulsion attacks in the examination room, she was introduced to our hospital. Every session of this psychotherapy was held once a week and for approximately 60 min at a time. Treatment process: She sometimes presented various eccentric attitudes, for example overturning to the floor with screaming (1), going down on her knees when entrance at the door (5), entering with a knife in her mouth and hitting the wall suddenly (7), stiffening herself just outside the door without entering the examination room (9), taking out a knife abruptly and putting it on her neck (40), exclaiming with convulsion responding to every talk from the therapist (41), or stiffening her face and biting herself in the right forearm suddenly (52). She also repeated self-injuries or convulsion attacks outside of the examination room in the early period of the therapy. Throughout the therapy she showed hypersensitivity for interpersonal relations, anxiety about dependence, terror for self-assertion, and avoidance for confrontation to her emotional problems. Two years and 6 months have passed since the beginning of this therapy. She ceased self-injury approximately 1 year and 6 months before and her sense of obscure terror has been gradually reduced to some extent. Discussion: Her non-verbal wariness and aggression to the therapist made the sessions full of tension and the therapist felt a sense of heaviness every time. In contrast, she could not express aggression verbally to the therapist, and when the therapist tried to identify her aggression she denied it. Her anxiety, that she will be thoroughly counterattacked to self-disintegration if she shows aggression to other persons, seems to be so immeasurably strong that she is compelled to deny her own aggression. Interpretations and confrontations by the therapist make her protective, and occasionally she shows stronger resistance in the shape of denial of her problems or conversion symptoms (astasia, aphonia, or involuntary movements) but she never expresses verbal aggression to the therapist. and the therapist feels much difficulty to share sympathy with her, and she expresses distrust against sympathetic approach of the therapist. However, her obvious disturbance that she expresses when she feels the therapist is not sympathetic shows her desire for sympathy. Thus, because she has both strong distrust and desire for sympathy, she is in a porcupine dilemma, which is characteristic of schizoid patients as to whether to lengthen or to shorten the distance between herself and the therapist. This attitude seems to have been derived from experience she might have had during her babyhood and childhood that she felt terror to be counterattacked and deserted when she showed irritation to her mother. In fact, existence of severe problems of the relationship between herself and her mother in her babyhood and childhood can be guessed from her statement. Although she has been repeating experiences to be excluded from other people, she shows no attitude to construct interpersonal relationship actively. On the contrary, by regarding herself to be a victim or devaluating other persons she externalizes responsibility that she herself should assume essentially. The reason must be that her disintegration anxiety is evoked if she recognizes that she herself has problems; that is, that negative things exist inside of her. Therefore, she seems to be inhibited to get depressive position and obliged to remain mainly in a paranoid,schizoid position. As for the pathological level, she seems to have borderline personality organization because of frequent use of mechanisms to externalize fantastically her inner responsibility. For her high ability to avoid confronting her emotional problems making the most of her verbal ability, every intervention of the therapist is invalidated. So, it seems very difficult for her to recognize her own problems through verbal interpretations or confrontation by the therapist, for the present. In general, it is impossible to confront self problems without containing negative emotions inside of the self, but her ability seemed to be insufficient. So, to point out her problems is considered to be very likely to result in her confusion caused by persecution anxiety. Although the therapy may attain the stage on which verbal interpretation and confrontation work better some day, the therapist is compelled to aim at promoting her ability to hold negative emotion inside of herself for the time being. For the purpose, the therapist is required to endure the situation in which she brings emotion that makes the therapist feel negative counter-transference and her process to experience that the therapeutic relation itself would not collapse by holding negative emotion. On supportive psychotherapy with a male adolescent Y. TERASHIMA Kitasato University Health Care Center, Kanagawa, Japan Adolescent cases sometimes show dramatic improvements as a consequence of psychotherapy. The author describes how psychotherapy can support an adolescent and how theraputic achievements can be made. Two and a half years of treatment sessions with a male adolescent patient are presented. The patient was a 19-year-old man, living with his family. He had 5 years of experience living abroad with his family and he was a preparatory school student when he came to a mental clinic for help. He was suffering from not being able to sleep well, from difficulties concerning keeping his attention on one thing, and from fear of going to distant places. He could barely leave his room, and imagined the consequence of overdosing or jumping out of a window. He claimed that his life was doomed because his family moved from a town that was familiar to him. At the first phase of psychotherapy that lasted for approximately 1 year, the patient seldom responded to the therapist. The patient was basically silent. He told the therapist that the town he lives in now feels cold or that he wants to become a writer. However, these comments were made without any kind of explanation and the therapist felt it very difficult to understand what the patient was trying to say. The sessions continued on a regular basis. However, the therapist felt very useless and fatigued. Problems with the patient and his family were also present at this phase of psychotherapy. He felt unpleasant at home and felt it was useless to expect anything from his parents. These feelings were naturally transferred to the therapist and were interpreted. However, interpretation seemed to make no changes in the forms of the patient's transference. The second phase of psychotherapy began suddenly. The patient kept saying that he did not know what to talk about. However, after a brief comment made by the therapist on the author of the book he was reading, the patient told the therapist that it was unexpected that the therapist knew anything of his favorite writer. After this almost first interaction between the patient and the therapist, the patient started to show dramatic changes. The patient started to bring his favorite rock CDs to sessions where they were played and the patient and the therapist both made comments on how they felt about the music. He also started asking questions concerning the therapist. It seemed that the patient finally started to want to know the therapist. He started communicating. The patient was sometimes silent but that did not last long. The therapist no longer felt so useless and emotional interaction, which never took place in the first phase, now became dominant. The third phase happened rapidly and lasted for approximately 10 months. Conversations on music, art, literature and movies were made possible and the therapist seldom felt difficulties on following the patient's line of thought. He started to go to schools and it was difficult at first but he started adjusting to the environment of his new part-time jobs. By the end of the school year, he was qualified for the entrance to a prestigious university. The patient's problems had vanished except for some sleeping difficulties, and he did not wish to continue the psychotherapy sessions. The therapist's departure from the clinic added to this and the therapy was terminated. The patient at first reminded the therapist of severe psychological disturbances but the patient showed remarkable progress. Three points can be considered to have played important roles in the therapy presented. The first and the most important is the interpretation by behavior. The patient showed strong parental transference to the therapist and this led the therapist to feel useless and to feel fatigue. Content analysis and here-and-now analysis seemed to have played only a small part in the therapy. However, the therapist tried to keep in contact with the patient, although not so elegant, but tried to show that the therapist may not be useless. This was done by maintaining the framework of the therapy and by consulting the parents when it was considered necessary. Second point is the role that the therapist intentionally took as a model or target of introjection. With the help of behavioral interpretation that showed the therapist and others that it may not be useless, the patient started to introject what seemed to be useful to his well being. It can be considered that this role took some part in the patient going out and to adjust to the new environment. Last, fortune of mach must be considered. The patient and the therapist had much in common. It was very fortunate that the therapist knew anything about the patient's favorite writer. The therapist had some experience abroad when he was young. Although it is a matter of luck that the two had things in common, it can be said that the congeniality between the patient and the therapist played an important role in the successful termination of the therapy. From the physical complaint to the verbal appeal of A's recovery process to regain her self-confidence C. ITOKAWA and S. KAZUKAWA Toyama Mental Health Center, Toyama, Japan This is one of the cases at Toyama Mental Health Center about a client here, we will henceforth refer to her simply as ,A'. A was a second grade high school student. We worked with her until her high school graduation using our center's full functions; counseling, medical examination and the course for autogenic training (AT). She started her counseling by telling us that the reason for her frequent absences from school began because of stomach pains when she was under a lot of stress for 2 years of junior high school, from 2nd grade to 3rd grade. Due to a lack of self confidence and a constant fear of the people around her, she was unable to use the transportation. She would spend a large amount of time at the school infirmary because she suffered from self-diagnosed hypochondriac symptoms such as nausea, diarrhea and a palpitation. She continued that she might not be able to have the self-confidence to sit still to consult me on her feelings in one of our sessions. A therapist advised her to take the psychiatric examination and the use of AT and she actually saw the medical doctor. In counseling (sessions), she eventually started to talk about the abuse that started just after her entering of junior high school; she approached the school nurse but was unable to tell her own parents because she did not trust them. In doing so, she lost the rest of her confidence, affecting the way she looked at herself and thought of how others did. At school she behaved cheerfully and teachers often accused her of idleness as they regarded this girl's absences along with her brightly dyed hair and heavy make-up as her negligent laziness. I, as her therapist, contacted some of the school's staff and let them know of her situation in detail. As the scolding from the teachers decreased, we recognized the improvement of her situation. In order to recover from the missed academic exposure due to her long absence, she started to study by herself. In a couple of months her physical condition improved gradually, saying ,These days I have been doing well by myself, haven't I?' and one year later, her improved mental condition enabled her to go up to Tokyo for a concert and furthermore even to enjoy a short part-time job. She continued the session and the medical examination dually (in tangent) including the consultation about disbelief to the teachers, grade promotion, relationships between friends and physical conditions. Her story concentrated on the fact that she had not grown up with sufficiently warm and compassionate treatment and she could not gain any mental refuge in neither her family nor her school, or even her friends. Her prospects for the future had changed from the short-ranged one with no difficulty to the ambitious challenge: she aimed to try for her favorite major and hoped to go out of her prefecture. But she almost had to give up her own plan because the school forced her to change her course as they recommended. (because of the school's opposition with her own choice). So without the trust of the teachers combined with her low self-esteem she almost gave up her hopes and with them her forward momentum. In this situation as the therapist, I showed her great compassion and discussed the anger towards the school authorities, while encouraging this girl by persuading her that she should have enough self-confidence by herself. Through such sessions, she was sure that if she continued studying to improve her own academic ability by herself she could recognize the true meaning of striving forward. and eventually, she received her parents' support who had seemed to be indifferent to her. At last she could pass the university's entrance exams for the school that she had yearned to attend. That girl ,A' visited our center 1 month later to show us her vivid face. I saw a bright smile on her face. It was shining so brightly. [source] | ||||||||||||||||||||||||||||||||||