Home About us Contact
|
Home About us Contact | ||
|
|
||
Embarrassment
Selected AbstractsAn Embarrassment of RichesJOURNAL OF INDUSTRIAL ECOLOGY, Issue 6 2009Reid Lifset No abstract is available for this article. [source] Teaching sexual history taking to health care professionals in primary careMEDICAL EDUCATION, Issue 6 2001John R Skelton Objectives Although it is accepted that history taking is central to correct diagnosis, little work has been undertaken on the development of sexual history taking, particularly in a primary care context where sexual health may not occur to the patient. Embarrassment is recognized as one major problem. This paper reports on a series of teaching interventions designed to help primary health care professionals (doctors and nurses) to identify and deal effectively with sexual health issues in the consultation. Methods 141 participants took part in nine different courses, with 114 returning evaluations. All courses involved tutorial teaching on clinical and ethicolegal issues and role play with trained professional role-players; some involved video-based dramatizations to particularize principles in context. During role play sessions, which were followed by detailed, contextualized feedback, clinical issues, attitudinal issues (e.g. articulating a sense of personal embarrassment, and the risk of stereotyping), and ethicolegal issues were all discussed, as were examples of words and phrases which participants were invited to try out. Outcomes The overall quality of the courses was rated by participants, on average, at 89·95 (maximum 100), and the relevance of the topic at 91·40. Free text comments centred on the power of the training as a consciousness raiser, on the need to alter communication strategies, the need to change existing clinical practice and the value of role play as a methodology. Interactive courses on sexual health are highly acceptable to participants. [source] Cortisol Response to Embarrassment and ShameCHILD DEVELOPMENT, Issue 4 2002Michael Lewis This study examined individual differences in 4,year,old children's (N= 60) expression of the self,conscious emotions of embarrassment and shame and their relation to differences in cortisol response to stress. Results indicated the presence of two different types of embarrassment,one that reflected negative evaluation of the self, and the other a nonevaluative type that reflected simply exposure of the self when the individual was the object of attention of others. Results also indicated a relation between a higher cortisol response to stress and the greater expression of the self,conscious emotions of evaluative embarrassment and shame that reflected negative self,evaluation. [source] Minocycline-Induced Hyperpigmentation Treated with a 755-nm Q-Switched Alexandrite LaserDERMATOLOGIC SURGERY, Issue 9 2004Tina S. Alster MD Background. Cutaneous pigmentation associated with minocycline therapy is an unusual adverse effect for which few successful treatments have been described. The pigment changes may persist for years, despite cessation of therapy, and is often cosmetically disfiguring, causing significant embarrassment and psychological depression in those affected. Few safe and effective treatments have been described in the past; however, recent pigment-specific laser technology has shown promise in the treatment of this condition. Objective. The objective was to describe a series of patients with minocycline-induced hyperpigmentation who were successfully treated with a 755-nm Q-switched alexandrite laser. Methods. Six patients with minocycline-induced hyperpigmentation on the face or legs were treated with a Q-switched alexandrite laser on a bimonthly basis until pigmentation was eradicated. Results. Cutaneous pigmentation resolved completely in all patients in an average of four laser sessions. Side effects were limited to transient purpura and mild desquamation without scarring or dyspigmentation. Conclusion. Minocycline-induced cutaneous pigmentation can be effectively cleared without risk of adverse sequelae by Q-switched alexandrite (755-nm) laser irradiation. [source] Personality, self-esteem, and self-construal as correlates of forgivingnessEUROPEAN JOURNAL OF PERSONALITY, Issue 1 2004Félix Neto The relationship between forgivingness (enduring resentment, sensitivity to circumstances, and overall propensity to forgive) and a number of personality dimensions relevant to forgivingness was examined. These dimensions were self-esteem, shyness and embarrassment, on one hand, and self-construal and perceived loneliness, on the other hand. The main relationships between forgivingness and personality concerned the interpersonal dimensions of personality: shyness, embarrassment, independence from others, and interdependence with others. However, the intra-personal, strictly self-referential concomitants of these dimensions (self-esteem and loneliness) were not much linked to forgivingness. Furthermore, each personality factor had a distinct link with forgivingness: independence made the resentment still more enduring, shyness and social embarrassment exacerbated the sensitivity to circumstances, and interdependence increased the willingness to forgive. These findings throw light on the double aspect of forgiveness as intra- and inter-individual and on the relative independence of these aspects. The observed pattern of relationships varied notably (and significantly) as a function of the participants' genders. It could be therefore important, in future studies, to compute systematically correlation coefficients or assess main effects separately for women and men. Copyright © 2003 John Wiley & Sons, Ltd. [source] The structure of negative emotion scales: generalization over contexts and comprehensivenessEUROPEAN JOURNAL OF PERSONALITY, Issue 2 2002Dirk J. M. Smits In this article, we tested whether a four-dimensional individual-difference structure of negative emotions (Sadness, Fear, Anger, Shame) as described e.g. by Diener, Smith and Fujita can be found in self-report data when the emotions are explicitly linked to three different specific contexts. In addition, we check the comprehensiveness of the structure by adding terms people spontaneously use to directly express negative affect. A situational questionnaire was constructed, based on the emotion terms from Diener et al., and it was administered to 161 participants. The structure we obtained was five dimensional instead of four dimensional: the Shame scale turned out to be two dimensional, with guilt and regret defining one factor, and shame and embarrassment defining another factor. Between these two, there is a moderate positive correlation. The structure is shown to be nearly identical for all three situations. The minor differences we found do contextualize the meaning of the emotional responses. The newly added terms could be captured quite well by the factor Anger. No separate factor was needed, meaning that the obtained five-dimensional structure may be considered comprehensive enough for the field of negative emotions. Copyright © 2002 John Wiley & Sons, Ltd. [source] Fixed drug eruption in NigeriaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2006Edith N. Nnoruka MBBS Fixed drug eruption (FDE) causes cosmetic embarrassment in Nigerian patients, particularly when the characteristic hyperpigmented patches affect the face and lips. Drugs that have been implicated in the etiology of FDE, and the sites of lesions, may vary from country to country. Antimalarials, such as Fansidar, Fancimef, Maloxine, Amalar, and Metakelfin, were the most common offending agents, accounting for 38% of FDEs, followed by trimethoprim + sulfamethoxazole (co-trimoxazole) (28%), dipyrones (10%), Butazolidin (6%), thiacetazone (6%), metronidazole (4%), paracetamol (3%), and naproxen (3%). Lesions induced by the combination of sulfadoxine and pyrimethamine (in antimalarials) mainly involved the face and lips. In most cases, patients took these sulfa-containing antimalarials in combination with numerous other drugs, particularly analgesics. Unlike chloroquine-induced pruritus, which affects most Africans, the association between antimalarials and FDE has not been well documented in our region. Co-trimoxazole was associated more often than antimalarials with FDEs involving the mucocutaneous junctions of the genitalia and lips. Males with genital lesions on the glans penis represented 11 (48%) of those with co-trimoxazole hypersensitivity. The trunk and limbs were affected mainly by pyrazoles and Butazolidin, respectively; however, solitary lesions on the trunk were usually due to co-trimoxazole, whereas solitary lesions on the limbs were associated with Butazolidin. [source] Women's experiences with vaginal pessary useJOURNAL OF ADVANCED NURSING, Issue 11 2009Sandra Storey Abstract Title.,Women's experiences with vaginal pessary use. Aim., This paper is a report of a study of the lived experiences of women using vaginal pessaries for the treatment of urinary incontinence (UI) and/or pelvic organ prolapse. Background., The use of a vaginal pessary offers a non-surgical treatment option to provide physical support to the bladder and internal organs. As the literature asserts, a woman's choice to use a pessary is very individual and involves not only physical, but also psychological and emotional considerations. Method., Narrative inquiry was used to conduct face-to-face semi-structured interviews in 2007 with 11 postmenopausal women who accessed services from a Urogynecology Clinic in Eastern Canada. Findings., The women's stories revealed that living with a pessary is a life-changing experience and an ongoing learning process. The women's comfort level and confidence in caring for the device figured prominently in their experiences. Psychosocial support provided by the clinic nurses also played a primary role in the women's experiences. Conclusion., Women and healthcare professionals need to be aware of the personal isolation and embarrassment, and social and cultural implications that urinary incontinence may cause as well as the subjective experiences of using a pessary. With appropriate support, vaginal pessaries can provide women with the freedom to lead active, engaged and social lives. [source] Lower urinary tract symptoms: a hermeneutic phenomenological study into men's lived experienceJOURNAL OF CLINICAL NURSING, Issue 2 2005BSc (Hons), Mark Wareing MSc Aim., This was an investigation to discover the lived experience of men with lower urinary tract symptoms arising from benign prostatic hyperplasic. Design., A hermeneutic phenomenological study. Methods., Approval was granted by the local Applied and Qualitative Research Ethics Committee (AQREC) prior to the commencement of the study. Data were gathered via semi-structured interviews that were audio taped, and subsequently transcribed. Each transcripted interview was analysed by the investigator and a team of ,expert readers'. The team agreed on a total of 57 sub-themes divided into seven categories with unanimity, therefore obviating the need for participant validation. Findings., The major findings of the study suggest that men experience a broad and dramatic spectrum of phenomena while living with a benign prostate condition. This includes profound embarrassment, fear, revulsion as well as humour that require a range of methods and life adjustments to manage and contain their symptoms. Conclusions., The participant's narratives provide a thick, rich and meaningful insight into how men understand their bodies, and make sense of prostate disease; a significant men's health issue. Relevance to clinical practice., Several studies have already been published describing men's lived experience of prostate surgery for benign prostatic hyperplasia. This research has captured men's lived experience of lower urinary tract symptoms ahead of surgical intervention. Men experience a broad scope of phenomena resulting from life with a benign prostate condition that encompasses fear and embarrassment and the development of coping mechanisms and changes in life style. Recent media awareness campaigns to raise public awareness of prostate disease as a men's health issue appear to be changing how men perceive their bodies, how they converse with one another, and their help seeking behaviour. [source] Preparation for Crisis Management: A Proposed Model and Empirical EvidenceJOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 3 2004S. Elsubbaugh This article explores the forces restricting effective crisis management in a crisis ridden industry. Models of crisis preparedness have typically been developed based upon research in US or Western business. This study is based upon the Egyptian industry which, until the 1990s was state owned and heavily state supported. Changes in government policy, combined with external forces, not in the least the loss of markets in the previous Soviet bloc, had plunged the industry into serious crisis. Crisis is a cultural embarrassment to most Egyptian managers and this, combined with the depth of economic difficulties faced by the industry, makes it extraordinarily difficult for any level of crisis preparedness to be achieved. Based on interview and questionnaire data, this article extends existing models of crisis preparedness to better accommodate conditions in crisis prone industries outside the West. New dimensions in the proposed model are the stress on national culture and how this limits the range of managerial responses. This in turn requires the active development of an organisational culture to counteract these limitations. [source] Struggling with an unfamiliar and unreliable body: the experience of irritable bowel syndromeJOURNAL OF NURSING AND HEALTHCARE OF CHRONIC ILLNE SS: AN INTERNATIONAL INTERDISCIPLINARY JOURNAL, Issue 1 2009Cecilia Håkanson MSc Aim., To describe the phenomenon living with irritable bowel syndrome from a life-world perspective. Background., Ten to twenty per cent of the adult population in the world is known to live with irritable bowel syndrome. The life-world experience of people with irritable bowel syndrome has been paid little attention. A deeper understanding about the phenomenon living with irritable bowel syndrome is of interest for the future development of care. Design and methods., The study was performed using a phenomenological method. Data was collected by in-depth, open interviews performed in 2006, with nine persons between 25,55 years, diagnosed with irritable bowel syndrome. The interviews were analysed according to the method of Giorgi. Results., Six interrelated key constituents have been identified: Having an altered self-image, feeling ashamed, distrusting the body, feeling tired, blaming oneself, and finding solutions. A structure has been formulated, describing that living with irritable bowel syndrome means struggling with an unfamiliar and unreliable body. Tiredness, distrust, and feelings of shame towards the body bring about limitations in everyday life. At the same time, living with irritable bowel syndrome means having a strong will to exceed the limitations and become familiar with one self. Conclusion., This study suggests that living with irritable bowel syndrome means to struggle with an unfamiliar and unreliable body that brings about changes of self-image and limitations in every day life. Feelings of distrust, shame and embarrassment towards troublesome symptoms, are important contributions to the limitations experienced. Relevance to clinical practice., Nurses have a major role to play in the care for people with irritable bowel syndrome. A caring perspective, in which the life-world is central, is an important approach to care for these persons. Using the dialogue as a forum where patients can share their unique life-world experiences lets nurses gather knowledge that is essential in helping patients identify and acknowledge new and positive understandings of the lived body. [source] Decision-making needs of patients with depression: a descriptive studyJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2008D. STACEY rn mscn phd The study's purpose was to explore the decision-making needs of patients considering treatment options for their depression. Semi-structured interviews were guided by the Ottawa Decision Support Framework. Of 94 participants, 67 were uncertain about their decision. Common decisions identified were whether or not to take medications, attend support groups, undergo electroconvulsive therapy, and location of care. Those feeling certain were more likely to have made a decision (RR 1.37; 95% CI: 1.05, 1.78). However, 40 patients who had ,made a decision' in the recent past were uncertain about their decision. Compared with those who were certain, the uncertain group felt less informed (2.65 vs. 1.64; P < 0.001), less supported (2.63 vs. 1.88; P < 0.001) and less clear about how they valued the benefits and risks of options (2.57 vs. 1.69; P < 0.001). Other influential factors included concerns about confidentiality, distress from depression, embarrassment, panic attacks and lack of energy. Few patients wanted to defer decision making to their physician (n = 8) or family (n = 1). To support decision making, participants identified the need for: discussions with their psychiatrist, nurse or family doctor; access to printed information; and information provided by health professionals and health societies. [source] A Comparison of Perspectives on Breastfeeding Between Two Generations of Black American WomenJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 1 2001Marjaneh M. Fooladi MSN, PhDArticle first published online: 24 MAY 200 PURPOSE To determine differences in breastfeeding perspectives between two generations of black American women with and without access to governmental food assistance programs (i.e., WIC). DATA SOURCES Descriptive, comparative study of a convenience sample of 118 black American women in their childbearing years and beyond conducted in a primary rural health care clinic serving an indigent population. CONCLUSIONS A significant difference was found between breastfeeding perceptions and rate among younger black American women on WIC program and their mothers without access to these programs. The availability of free formula through WIC programs has partially influ-enced the rate of breastfeeding among the young black American women. The other sig-nificant influencing factor was public embarrassment at breastfeeding. IMPLICATIONS FOR PRACTICE An extensive educational campaign is needed in order to influence the public's perceptions of breastfeeding as an embarrassment. The success of programs such as WIC must be measured beyond the first six months of an infant's life. [source] Patient acceptance and clinical impact of Bravo monitoring in patients with previous failed catheter-based studiesALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2009R. SWEIS Summary Background, Standard pH monitoring is performed over 24 h with a naso-oesophageal catheter (C-pH). Limitations include naso-pharyngeal discomfort, nausea and social embarrassment resulting in reduced reflux-provoking activities. Recently a catheter-free pH-monitoring technique has become available. The tolerability and diagnostic yield of this system in patients who failed standard monitoring remain unknown. Aim, To examine the tolerability and diagnostic outcome of catheter-free pH-monitoring technique in patients who failed standard monitoring. Methods, Patients referred for C-pH and catheter-free pH monitoring completed a tolerability questionnaire. Acid exposure in the distal oesophagus and symptom index (SI) were reviewed. Results, Over 4 years, 883/1751 (50%) of patients with typical reflux symptoms referred for C-pH were diagnosed with gastro-oesophageal reflux disease (GERD) based on a pathological percentage time acid exposure (%time pH <4);134 (8%) patients failed C-pH and, of these, 129 successfully completed 2-day catheter-free pH monitoring. Ninety-eight (76%) of these patients had a pathological percentage pH <4 on either day compared with 49/102 (49%) of contemporaneous C-pH patients (P < 0.01). There was no difference in SI for heartburn (35% vs. 42%; P = 0.49). The questionnaire demonstrated a preference for catheter-free pH monitoring (96%) with less restriction in activities of daily living, naso-pharyngeal discomfort, dysphagia and chest pain. Conclusions Tolerance and satisfaction with catheter-free pH monitoring are high in patients who had previously failed C-pH; catheter-free pH monitoring assists the definitive diagnosis of GERD in this group. [source] Teaching sexual history taking to health care professionals in primary careMEDICAL EDUCATION, Issue 6 2001John R Skelton Objectives Although it is accepted that history taking is central to correct diagnosis, little work has been undertaken on the development of sexual history taking, particularly in a primary care context where sexual health may not occur to the patient. Embarrassment is recognized as one major problem. This paper reports on a series of teaching interventions designed to help primary health care professionals (doctors and nurses) to identify and deal effectively with sexual health issues in the consultation. Methods 141 participants took part in nine different courses, with 114 returning evaluations. All courses involved tutorial teaching on clinical and ethicolegal issues and role play with trained professional role-players; some involved video-based dramatizations to particularize principles in context. During role play sessions, which were followed by detailed, contextualized feedback, clinical issues, attitudinal issues (e.g. articulating a sense of personal embarrassment, and the risk of stereotyping), and ethicolegal issues were all discussed, as were examples of words and phrases which participants were invited to try out. Outcomes The overall quality of the courses was rated by participants, on average, at 89·95 (maximum 100), and the relevance of the topic at 91·40. Free text comments centred on the power of the training as a consciousness raiser, on the need to alter communication strategies, the need to change existing clinical practice and the value of role play as a methodology. Interactive courses on sexual health are highly acceptable to participants. [source] A Holistically Deweyan FeminismMETAPHILOSOPHY, Issue 3 2001Jane Duran The argument that a holistic analysis of Dewey's work, drawing not only on the major portions subject to extensive commentary (such as Experience and Nature) but also on his aesthetics, provides fuel for feminist theorizing is sustained by advertence to the standard commentary and also to new work in aesthetic feminism itself. Sleeper, Rorty, Hickman and Russell are cited, and the recent resurgence of interest in developing the intersection between analytic aesthetics and feminist aesthetics is alluded to. It is concluded that the enterprising feminist theorist may suffer from an embarrassment of riches in attempting to approach Dewey but that such an approach is well worth the effort. [source] Sialorrhea in Parkinson's disease: A reviewMOVEMENT DISORDERS, Issue 16 2007Kelvin L. Chou MD Abstract A significant number of patients with Parkinson's disease (PD) experience sialorrhea. This problem can cause social embarrassment, and because saliva pools in the mouth, may lead to aspiration pneumonia. Sialorrhea in PD is thought to be caused by impaired or infrequent swallowing, rather than hypersecretion. Oral medications, botulinum toxin injections, surgical interventions, radiotherapy, speech therapy, and trials of devices may be used to treat sialorrhea in PD, but few controlled trials have been published. This article reviews current knowledge regarding the frequency, etiology, assessment, and treatment of sialorrhea in PD. © 2007 Movement Disorder Society [source] Botulinum toxin a may be efficacious as treatment for jaw tremor in Parkinson's diseaseMOVEMENT DISORDERS, Issue 10 2006Susanne A. Schneider MD Abstract Jaw tremor in Parkinson's disease (PD) may not respond well to conventional treatment. It causes embarrassment and social handicap. We piloted the use of botulinum toxin (BTX) injections in three patients with PD jaw tremor. BTX A (Dysport; mean, 53 U; range, 30,100 U) was given into each masseter muscle. Outcome was assessed by subjective and clinical improvement and by video recording before and 4 to 9 weeks after injections. There was an excellent response in all without side effects. BTX injections into the masseter may effectively improve jaw tremor and be useful in PD and other conditions. © 2006 Movement Disorder Society [source] Communities of complicity: Notes on state formation and local sociality in rural ChinaAMERICAN ETHNOLOGIST, Issue 3 2010DR. HANS STEINMÜLLER ABSTRACT In this article, I deal with the tension in rural China between vernacular practice in local sociality and official representations related to processes of state formation and with the ways in which this tension is revealed and concealed through gestures of embarrassment, irony, and cynicism. Such gestures point toward a space of intimate self-knowledge that I call a "community of complicity," a concept derived from Michael Herzfeld's outline of "cultural intimacy." I illustrate how such communities are constituted with examples involving Chinese geomancy (fengshui), funerary rituals, and corruption. I contrast this approach with arguments made about "state involution" in China. [source] Measuring health-related quality of life in women with urogenital dysfunction: The urogenital distress inventory and incontinence impact questionnaire revisitedNEUROUROLOGY AND URODYNAMICS, Issue 2 2003C. Huub van der Vaart Abstract Aims Symptoms of urogenital dysfunction are known to negatively affect health-related quality of life in women. To assess effectiveness of treatment, it is currently recommended to include measurements of quality of life in outcome analysis. One of the questionnaires that is commonly used is the combination of the Urogenital Distress Inventory (UDI) and Incontinence Impact Questionnaire (IIQ). Unfortunately, the validity of the UDI and IIQ has only been tested in highly selected subgroups of female patients. Therefore, it is unclear whether this questionnaire is suitable for use in populations with different characteristics. Methods We analyzed the scale construction and validity of the UDI and IIQ in a random sample of 2,042 women, aged 20,70 years old and a clinical sample of 196 women. Results Our results show that the UDI can be divided into five subscales, namely discomfort/pain, urinary incontinence, overactive bladder, genital prolapse, and obstructive micturition. The internal consistency (Cronbach's alpha) ranged between 0.74 and 0.82. In addition to the original four subscales of the IIQ (mobility, physical, social, and emotional functioning), we identified a fifth subscale with four items about embarrassment. Internal consistency of these subscales ranged between 0.83 and 0.93. In addition to the internal consistency, we tested the criterion and construct validity of these new subscale division. Conclusions We found these subscales to be reliable and of clinical use. It is recommended to use the revised UDI and IIQ in outcome analysis of treatments for urogenital symptoms in women. Neurourol. Urodynam. 22:97,104, 2003. © 2003 Wiley-Liss, Inc. [source] The cachet dilemma: Ritual and agency in new Dutch nationalismAMERICAN ETHNOLOGIST, Issue 1 2010OSKAR VERKAAIK ABSTRACT In 2006, the Dutch government introduced a naturalization ceremony for foreigners wishing to become Dutch citizens. Local bureaucrats who organize the ceremony initially disapproved of the measure as symbolic of the neonationalist approach to migration. I analyze how their criticism is undermined in the process of designing the ritual, the form of which continues to express a culturalist message of citizenship, despite organizers' explicit criticism or ridicule. Using the concept of "cultural intimacy," I show how nationalism builds on a shared embarrassment among local bureaucrats, from which the new citizens are excluded by way of the ceremony. [source] Exomphalos , a major or minor problem?PEDIATRIC ANESTHESIA, Issue 9 2002T. O'Neill Introduction The mortality and morbidity statistics associated with exomphalos major remain discouraging despite advances in management techniques (1). Congenital lung pathology, in particular pulmonary hypoplasia, and thoracic maldevelopment, have been strongly allied to this condition, accounting for the high incidence of pulmonary insufficiency necessitating prolonged ventilatory support in these infants (2). We discuss the respiratory issues in an infant with a particularly severe form of exomphalos major, and the impact of a comprehensive parental website devoted to the infants' management and progress. Case Report A female infant, born at 38 weeks' gestation, was referred for management of exomphalos major. Due to the extensive nature of the abdominal wall defect, primary surgical closure was impossible and initial management consisted of staged reduction by external compression of the exomphalos. This resulted in escalating cardiovascular and respiratory embarrassment, and was abandoned in favour of conservative treatment, whereby the sac was dressed and allowed to epithelialise. Thereafter the clinical course was characterised by chronic pulmonary insufficiency requiring prolonged ventilatory support. Ventilator dependence did not significantly decrease until lung growth occurred and the sitting position was adopted, enabling weaning from conventional ventilation to genuine BIPAP at 6 months. Currently, after 11 months, we are preparing her for entry into a home ventilation programme. Throughout this period, progress and realistic goals were discussed at multidisciplinary case conferences involving the parents. The interpreted medical management has subsequently been displayed by the parents on an elaborate, up-to-date website, which is part of a larger ,Mother Of Omphalocele' network. Although innovative, this highlights the fact that we the medical profession, should be vigilant with regard to potential public exposure of patient management. Whilst the Internet has become an integral part of our own continuing education, this case highlights a new aspect of how it may be used by our patients and their relatives to compare and contrast management policies in various institutions. [source] Double-Blind, Randomized, Placebo-Controlled Trial of the Use of Topical 10% Potassium Hydroxide Solution in the Treatment of Molluscum ContagiosumPEDIATRIC DERMATOLOGY, Issue 3 2006Katherine A. Short M.R.C.P. Lesions take between 6 and 18 months to resolve spontaneously and are a source of great embarrassment to both caretakers and children, often affecting attendance at school and limiting social activity. Treatment options to date have been poorly tolerated by children but recent studies have suggested that potassium hydroxide may be beneficial. This double-blind, randomized, placebo-controlled study compared 10% potassium hydroxide with placebo (normal saline). Twenty patients, aged 2 to 12 years, were recruited. Parents applied a solution twice daily to lesional skin until signs of inflammation appeared. Children were examined by the same observer on days 0, 15, 30, 60, and 90. Seventy percent of children receiving topical potassium hydroxide cleared, compared with 20% in the placebo group. Further dosing studies are required to identify whether weaker concentrations of potassium hydroxide are as efficacious, with less irritancy. [source] Intralesional bleomycin injections in the treatment of benign lymphoepithelial cysts of the parotid gland in HIV-positive patients: Case reports,THE LARYNGOSCOPE, Issue 2 2010Glen M. Monama MBChB, MMed (ORL) Abstract Benign lymphoepithelial cysts (BLCs) of the parotid gland are associated with human immunodeficiency virus. These cysts may grow large and uncomfortable, causing significant cosmetic embarrassment for the patient. Several treatment options have been described with varying successes. We report successful treatment of three adults with bleomycin. All three patients presented with bilateral parotid enlargements. They received a total dose of between 180 U and 270 U of bleomycin over a period of 6 to 10 weeks. They all responded completely without morbidity or recurrence. Bleomycin is effective in the treatment of BLCs of the parotid glands in HIV-positive patients. Laryngoscope, 2010 [source] Tracheolaryngeal Complications of Inherited Epidermolysis Bullosa: Cumulative Experience of the National Epidermolysis Bullosa Registry,THE LARYNGOSCOPE, Issue 9 2007Jo-David Fine MD Abstract Objectives/Hypothesis: To accurately determine the frequency with which complications arise in the ears, noses, and throats of patients with inherited epidermolysis bullosa (EB) as well as the cumulative risk of tracheolaryngeal stenosis or stricture. Study Design: Cross-sectional study (3,280 patients) with a nested, randomly sampled longitudinal subcohort (n = 450), representing data collection, stratified by major EB subtype, of the National EB Registry, an epidemiologic project focused on enrolling all EB patients within the continental United States from 1986 to 2002, to permit generalization of findings to the entire American EB population. Methods: Systematic epidemiologic case finding and data collection were performed throughout the continental United States, followed by subclassification of patients by EB subtype. ENT complications were quantified via contingency tables (as frequencies) and lifetable analyses. Frequencies of surgical procedures were also determined. Results: The most important clinical ENT complication in inherited EB was tracheolaryngeal stenosis or stricture, arising during early childhood and primarily within infants and children with junctional EB (JEB) (cumulative risk of 39.8% and 12.8% in Herlitz and non-Herlitz JEB, respectively, by ages 6 and 9). Other uncommon complications included chronic otitis media, chronic otitis externa, and hearing loss. Conclusions: Given the potential risk for sudden airway occlusion and death, meticulous surveillance by a pediatric otolaryngologist is a critical part of the overall management of infants and children with EB, especially those with JEB and two rare subtypes of generalized EB simplex. Elective tracheostomy should be considered in EB infants and children with evidence of airway embarrassment. [source] Anaesthesia for an adult with Angelman syndromeANAESTHESIA, Issue 11 2009M. Maguire Summary Angelman syndrome is a complex genetic condition involving abnormalities of chromosome 15 in the majority of cases. These defects involve a gene encoding an ubiquitin protein ligase and may be associated with abnormal ,-aminobutyric acid (GABA)A receptor subunits. Angelman syndrome may have profound implications for anaesthesia: potential exists for airway difficulties; refractory bradyarrythmias; and pharmacodynamic unpredictability. A case of an adult with Angelman syndrome undergoing dental work under general anaesthesia is presented. Induction and maintenance of anaesthesia was unremarkable but emergence was complicated by generalised muscular hypertonia and temporary respiratory embarrassment which resolved spontaneously. [source] A real reason for patients with pseudobulbar affect to smileANNALS OF NEUROLOGY, Issue 2 2007Howard J. Rosen MD Pseudobulbar affect (PBA) is a dramatic disorder of emotional expression and regulation characterized by uncontrollable episodes of laughing and crying that often cause embarrassment, curtailment of social activities, and reduction in quality of life. The disorder occurs in patients with brain injury caused by many types of neurological disease, including stroke, tumors, and neurodegenerative gray and white matter disorders. Although the pathophysiology is unknown, PBA may relate to release of brainstem emotional control centers from regulation by the frontal lobes. Diagnosis of PBA can be difficult and relies on careful characterization of episodes and differentiation from depression. Although there are no US Food and Drug Administration,approved treatments for PBA, several agents have been shown to be effective, including tricyclic antidepressants, selective serotonin reuptake inhibitors, and a new agent containing dextromethorphan and quinidine. The growing number of treatment options, some of great benefit to patients, highlights the importance of accurate diagnosis of this disorder. Ann Neurol 2007 [source] Front and Back Covers, Volume 22, Number 5.ANTHROPOLOGY TODAY, Issue 5 2006October 200 Front and back cover caption, volume 22 issue 5 Front cover Kayapo men of Brazilian Amazonia dance at a meeting of all Kayapo villages held in March 2006 with the aim of forging a united movement against the encroachment of agribusiness and large-scale development projects into the Xingú river valley. Up to the time of this meeting the widely dispersed Kayapo communities had never joined together as a single political organization under a common leadership. That they were able to do so at this meeting owed much to their ability to draw upon their shared tradition of collective ritual dance performances, which serve as the principal means of reproducing the social and political structures of their separate villages. At the meeting, held at the Kayapo village of Piaraçu on the Xingú, members of rival communities with mutually suspicious leaders joined in dances such as this one, drawn from the ritual for war, that expressed their solidarity in opposition to the common external threat. For the general audience, periodic interludes of dancing also provided a dramatic way of showing solidarity with one another and jointly expressing support for the orators, who were mostly leaders of the different communities. The meeting closed with a new ritual created for the occasion that began with a collective dance and culminated in a rite symbolizing the new level of common chiefly authority and leadership, encompassing Kayapo society as a whole, that had been created at the meeting. Back cover COMPETITIVE HUMANITARIANISM The back cover of this issue shows a detail from a map of ,Humanitarian actors involved in tsunami-related activities in Sri Lanka'. This excerpt lists but a few dozen of the many hundreds of agencies competing to provide relief in the wake of the tsunami that hit Sri Lanka in December 2004. In most disasters, a major problem facing relief agencies is a lack of resources. In the case of the 2004 tsunami, however, agencies were forced into competition with each other for effective distribution of an embarrassment of riches. Yet this distribution had to be in line with international standards, and needed to meet the requirements of those who had donated to the various appeals in other parts of the world and had specific ideas of what constituted relief. The result was an over-concentration on the visible and the photogenic rather than the arguably more important work of rebuilding institutions and social networks. As well as needing to meet international standards, relief agencies were subject to the bureaucratic requirements that they should expend their resources in an accountable fashion. Their slow reaction opened the way for a plethora of small and inexperienced organizations (and individuals) to enter the relief business. The aid they dispensed was often poorly directed and technically inferior, but the visibility of their operations prompted an easy criticism of the more ponderous activities of the larger relief organisations. While ready availability of resources marked out the tsunami relief effort from most other disasters, what seems to characterize aid operations in the wake of such disasters is a high degree of competition between relief agencies, and a continual call for a greater degree of co-ordination between relief organizations. Yet competitive pressures mean that co-ordination is unlikely to be attainable over more than the short term. From an anthropological point of view the following paradox is worthy of study: while philanthropy can be seen as the antithesis of self-interest, philanthropic organisations are inherently part of a self-interested, market-orientated social order. What starts out as a ,free gift' from the public of Europe, Asia or elsewhere ends up as a commodity in the marketplace of competitive humanitarianism. [source] Implantation of ethylene vinyl alcohol copolymer for faecal incontinence managementANZ JOURNAL OF SURGERY, Issue 5 2010Jacqueline H. Stephens Abstract Purpose:, The primary objectives of this trial were to evaluate the safety and feasibility of treatment and to gain a preliminary indication of the effectiveness of ethylene vinyl alcohol injections into the anal sphincters of faecally incontinent patients. Methods:, Between April 2004 and February 2006, we conducted a prospective, single-arm, procedure optimization study of ethylene vinyl alcohol injections in 21 subjects with well-characterized faecal incontinence and an intact external anal sphincter at two Australian hospitals. Results:, There was a significant decrease in the Cleveland Clinic Florida Faecal Incontinence Score (CCFFIS) (P= 0.0005) and the Faecal Incontinence Severity Index score (P= 0.005) after treatment. At 12 months post-treatment, the mean CCFFIS had decreased by 37% (P= 0.0021), and 47% of subjects had a ,50% improvement in CCFFIS. There were significant improvements in embarrassment (P= 0.0455) and coping/behaviour (P= 0.0056) domains of the Faecal Incontinence Quality of Life. At 12 months, the mean anal canal length had increased by 29% (P= 0.066), with 40% of patients demonstrating increases of 50% or more. There were no further improvements following retreatment. Conclusions:, Ethylene vinyl alcohol injection into the anal intersphincteric plane is feasible and well tolerated. Improvement in faecal incontinence compared with baseline was seen. Retreating initial non-responders was not successful. [source] Personal and cultural differences in responding to criticism in three countriesASIAN JOURNAL OF SOCIAL PSYCHOLOGY, Issue 2 2002Mary Jiang Bresnahan The present study investigated whether verbal aggression, argument approach, argument avoidance or assertiveness had any effect on how participants in three countries responded to criticism. Consistent with the first hypothesis, men were significantly more aggressive, assertive, less avoidant, and approached argument more than women. However, men did not respond more assertively to criticism. As predicted in the second hypothesis, US Americans responded more assertively to criticism than did Japanese and Chinese. The third hypothesis predicted that verbal aggression, argument approach, argument avoidance and assertiveness would be associated with a more assertive response to criticism. The data obtained were only partially consistent with the third hypothesis. While only a small number of participants in this study indicated that they would respond to criticism with silence, US Americans used silence to mean anger while for Chinese silence showed personal embarrassment. Very few Japanese selected silence as an option for responding to a neighbor's criticism. The implications of these results are discussed. [source] | |||||||||||||||||||||||||||||||||||||