“It’s both a strength and a drawback.” How therapists’ personal qualities are experienced in their professional work

ABSTRACT

Objective: The aim of this study was to gain knowledge about how the integration of personal and professional experiences affects therapeutic work. Method: Therapists (N?=?14) who had been recommended by their leaders at their individual workplaces were interviewed twice with semi-structured qualitative interviews, which were then subjected to thematic and Interpretative Phenomenological Analysis. Results: All the therapists in the sample described their personal qualities as an experienced tension between their personal strengths and vulnerabilities in the therapeutic setting. This tension came to expression through four subordinate themes: (a) The tension between perceiving oneself as a helper while dealing with one’s own needs for attention and care; (b) The tension between the ability for embodied listening to the patient while tuning into oneself; (c) The tension between staying present while handling aggression and rejection from clients; and (d) The tension in striving for a constructive balance between closeness and distance. Conclusion: The results point to ways in which the personal selves of the therapists may affect their professional role performance. Drawing upon previous research and literature on the topic, the paper discusses how therapists’ personal qualities are experienced as affecting their work and suggests several implications for psychotherapy training and practice.     

Subwavelength Etched Colloidal Monolayers: A Model System for Tunable Antireflective Coatings

Colloidal monolayers represent a versatile material class to fabricate nanostructures with high quality. The length scale of the nanostructured film is given by the size of the colloidal nanoparticles. Importantly, colloidal monolayers, though being of hexagonally close packed symmetry, still embody a high amount of free volume. This reduces the effective refractive index of thin colloidal monolayer films significantly. For particles and periodicities <200 nm, the heterogeneous layer can be approximated by an effective medium theory. The amount of free volume can be further fine‐tuned by a controlled size reduction of the constituting spheres, for instance by plasma etching. This can be utilized to realize an optimum refractive index for the application of colloidal monolayers as antireflective (AR) coatings. In contrast, previously reported >200 nm monolayers demonstrate distinct extinction peaks due to grating diffraction. Rational design by the use of differently sized particles further allows shifting the best performance across the visible spectrum. Colloidal monolayers, though representing single‐layer AR coatings, exhibit broadband AR properties and are ideally suited to demonstrate the influence of refractive index and layer thickness, independently.

     

Does experience predict observational kinematic assessment accuracy?

Observation of patients' movements forms an integral part of the development of therapeutic treatment plans for neurological patients. In this study we investigated the influence of clinical experience on the accuracy of observational kinematic assessment (OKA) of upper limb movements. Twenty-one physiotherapists and 15 students participated. The less experienced (LE) group ( n = 11) had a mean of 2.8 years ( &#45 1.8 years) of clinical experience and the highly experienced (HE) group ( n = 10) had a mean of 10.5 years ( &#45 2.2 years) of experience. The novice group (N) consisted of students in the third year of their Physiotherapy degree. Highly experienced, LE, and N participants observed the videotaped movements of healthy and neurologically impaired performers and made visual judgments about the speed, jerkiness, and path indirectness of performances, recording their judgments on visual analogue scales. We compared observers' judgments with kinematic indices derived from three-dimensional computer-assisted motion analysis to determine OKA accuracy. All groups of observers made moderate to highly accurate judgments with no significant differences between groups. Furthermore, inter-rater reliability was not experience-dependent. We discuss why experiential differences might be absent and provide suggestions for future development of OKA.     

Humans possess two mitochondrial ferredoxins,Fdx1 and Fdx2, with distinct roles in steroidogenesis,heme, and Fe/S cluster biosynthesis

Mammalian adrenodoxin (ferredoxin 1; Fdx1) is essential for the synthesis of various steroid hormones in adrenal glands. As a member of the [2Fe-2S] cluster-containing ferredoxin family, Fdx1 reduces mitochondrial cytochrome P450 enzymes, which then catalyze; e.g., the conversion of cholesterol to pregnenolone, aldosterone, and cortisol. The high protein sequence similarity between Fdx1 and its yeast adrenodoxin homologue (Yah1) suggested that Fdx1, like Yah1, may be involved in the biosynthesis of heme A and Fe/S clusters, two versatile and essential protein cofactors. Our study, employing RNAi technology to deplete human Fdx1, did not confirm this expectation. Instead, we identified a Fdx1-related mitochondrial protein, designated ferredoxin 2 (Fdx2) and found it to be essential for heme A and Fe/S protein biosynthesis. Unlike Fdx1, Fdx2 was unable to efficiently reduce mitochondrial cytochromes P450 and convert steroids, indicating that the two ferredoxin isoforms are highly specific for their substrates in distinct biochemical pathways. Moreover, Fdx2 deficiency had a severe impact, via impaired Fe/S protein biogenesis, on cellular iron homeostasis, leading to increased cellular iron uptake and iron accumulation in mitochondria. We conclude that mammals depend on two distinct mitochondrial ferredoxins for the specific production of either steroid hormones or heme A and Fe/S proteins.     

Hematoporphyrin-derived soluble porphyrin-platinum conjugates with combined cytotoxic and phototoxic antitumor activity

To combine the cytotoxic activity of cisplatin and the phototoxicicity of hematoporphyrin derivatives in the same molecule, hematoporphyrin was derivatized at the two secondary alcohol positions by etherification with oligo- and poly(ethylene glycol) units. The two carboxylic acid groups of the propionate side chains were used to bind platinum fragments. The antiproliferative activity of 35 platinum complexes (0.5, 1, and 5 microM) differing in solubility and type of the platinum fragment and the corresponding porphyrin ligands were studied in tests with TCC-SUP and J82 transitional bladder cancer cells in the dark and after irradiation (lambda = 600-730 nm, 24 J/cm(2)). The most active compounds were found among the porphyrin-platinum conjugates bearing the diammine and (RR/SS)-trans-1,2-diaminocyclohexane ligand. These porphyrin-platinum conjugates, especially the water-soluble species, such as diammine(7,12-bis[1-(poly(ethylene glycol)-750-monomethyl ether-1-yl)ethyl]-3,8,13,17-tetramethylporphyrin-2,18-dipropionato)platinum(II), are promising candidates for the development of a novel type of photosensitizers with intrinsic cytotoxicity, which due to the porphyrin constituent may selectively enrich in tumor tissues.     

In-stream uptake dampens effects of major forest disturbance on watershed nitrogen export

Between January 4 and 10, 1998, a severe ice storm impacted large areas of northern New York, New England, and eastern Canada. This storm struck the Hubbard Brook Experimental Forest in New Hampshire on January 7-8, 1998, and caused extensive forest crown damage (>30%) in a narrow elevation band (600-740 m) across the south-facing experimental watersheds. Stream water has been collected and chemically analyzed since 1963 in six experimental watersheds at Hubbard Brook Experimental Forest; thus, we were able to examine the effect of this severe natural disturbance on watershed nutrient export and changes in instream nitrate (NO3-) processing. The ice storm caused large increases in watershed export of NO3- for 2 years after the disturbance, but our examination of in-stream processing suggests that NO3- losses would have been much more dramatic had there not been an increase in in-stream, nitrogen-processing efficiency after the ice storm. The canopy damage that resulted from the ice storm led to increased light availability and large inputs of woody debris to the stream. We suspect that increases in algal production and storage and processing of terrestrial litter account for the increase in inorganic nitrogen processing in these streams. Our results indicate that, without in-stream processing, export of NO3- from the damaged watersheds would have been 80-140% higher than was observed. These results point to an intriguing negative feedback mechanism whereby the same disturbance that causes watershed NO3- loss may simultaneously lead to increased in-stream retention and transformation.     

Influence of voriconazole and fluconazole on Candida albicans in long-time continuous flow culture

We investigated the influence of voriconazole and fluconazole in a long term trial of continuous flow culture (cfc) up to 9 days. The effects of these azoles were different in dependence on the growth circumstances. Under anaerobic conditions a fungicidal effect of voriconazole was detectable, defined by an inhibition of 99.9%. This also applied to fluconazole for the majority of tested strains of C. albicans. Under aerobic conditions with an otherwise similar situation we found only a fungistatic reaction (inhibition of 90%). Fluorescence microscopy comparing fungal morphology in biofilms on glass surfaces in the cfc revealed a differentiation into blastospores, germ tubes, pseudomycelia and mycelia in the control trial after a cultivation of 8 days. Under anaerobic conditions with azoles only some single cells could be found, sometimes in cell detritus. The adhesion was clearly reduced. Under aerobic conditions more blastospores but no differentiated mycelia were to be seen.     

Regulatory aspects of noninvasive glucose measurements

The Medical Device Amendments of 1976 to the Federal Food, Drug, and Cosmetic Act (the Act) established three regulatory classes for medical devices. Section 513 of the Act specifies three classes based upon the degree of control and Food and Drug Administration (FDA) oversight that is necessary to assure that the various types of devices are safe and effective. High-risk devices are placed into the most regulated device class, Class III. Under Section 515 of the Act, all devices placed in Class III are subject to premarket approval (PMA) requirements. PMA by FDA is the required process of scientific review to ensure the safety and effectiveness of Class III devices. Advisory panel review is required of virtually all original submissions. Manufacturing facilities of devices requiring PMA approval are also subject to preapproval inspection to assure data integrity and compliance with good manufacturing practices. An approved PMA is granted for marketing a particular medical device for a particular intended use. FDA considers noninvasive and minimally invasive glucose devices that are intended to measure, monitor, or predict blood glucose levels in diabetics to be high-risk medical devices. These devices will have a significant potential impact on the medical care of people with diabetes. The technology offers potential improvements in the quality of life, enhanced blood glucose control through increased frequency of testing, or access to testing, in a broader range of patients. However, the technology is not yet well understood, and the information obtained from these devices is often different from the information that has been the traditional base for the management of diabetes. As a result, FDA requires both analytical and clinical studies to support the intended claims for these new devices.     

Dynamic sonography with valgus stress to assess elbow ulnar collateral ligament injury in baseball pitchers

Sonography is a valuable method for imaging superficial tendons and ligaments. The ability to obtain comparison images easily with dynamic stress allows assessment of ligament and tendon integrity. We studied the medial elbow joints of two baseball pitchers using MR imaging and dynamic sonography. Both sonography and MR imaging identified the ulnar collateral ligament tears. Dynamic sonography uniquely demonstrated the medial joint instability.