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[Defense mechanisms].

Defence mechanisms are mental operations that are involuntary and unconscious and contribute to reduce internal and external stresses. The concept of defensive organisation or style, defined as a set of defence mechanisms relatively stable and characteristic of personality appears to be a major dimension of personality, from normal to pathology. Studies on defence mechanisms have gained the interest of clinicians, largely outside the psychoanalytical field. However, the lack of reliability and validity of the assessment instruments still limits the empirical studies of the relation between def

Early physical and functional rehabilitation of trauma patients in the Médecins Sans Frontières trauma centre in Kunduz, Afghanistan: luxury or necessity?

BACKGROUND: In Afghanistan, Médecins Sans Frontières provided specialised trauma care in Kunduz Trauma Centre (KTC), including physiotherapy. In this study, we describe the development of an adapted functional score for patient outcome monitoring, and document the rehabilitation care provided and patient outcomes in relation to this functional score. METHODS: A descriptive cohort study was done, including all patients admitted in the KTC inpatient department (IPD) between January and June 2015. The adapted functional score was collected at four points in time: admission and discharge from bot

Survey of residents who have participated in humanitarian medical missions.

PURPOSE: To survey physicians who participated in humanitarian missions as residents to assess the value of this experience on residency training and future career choices. MATERIALS AND METHODS: An anonymous 26-question survey was electronically mailed to 45 individuals identified as having participated in a cleft lip/palate mission during residency. The survey was created and distributed, and the data were collected using the online survey engine Survey Monkey. RESULTS: Thirty-nine individuals (86.7%) completed the survey. Of these, 27 were men (69.2%) and 12 were women (30.8%). Thirty-two

The counselor's trauma as counseling motivation: vulnerability or stress inoculation?

Should counselors with interpersonal trauma histories work with similarly traumatized clients? How does the work affect them? Current research is inconsistent. This study examines 101 sexual assault and domestic violence counselors' recalled motivations for trauma work, their reported subjective personal changes, and their secondary and vicarious trauma symptoms and burnout. Counselors motivated by interpersonal trauma report both more symptoms and positive changes (including dealing with their own trauma). Those seeking personal meaning report becoming more hypervigilant and self-isolating. T

Organ transplantation: contemporary Sunni Muslim legal and ethical perspectives.

The problems that organ transplantation poses to the Muslim mind may be summarized as follows: firstly, a Muslim believes that whatever he owns or possesses has been given to him as an amanah (trust) from Allah. Would it not be a breach of trust to give consent for the removal of parts of one's body, while still alive, for transplantation to benefit one's child, sibling or parent? Secondly, the Shari'ah (Islamic Law) emphasizes the sacredness of the human body. Would it not then be an act of aggression against the human body, tantamount to its mutilation, if organs were to be removed after dea

Seriously ill patients as living unspecified kidney donors: rationale and justification.

BACKGROUND: Between 2000 and December 2013, 106 live donor nephrectomies from anonymous living-donors were performed at the Erasmus MC Rotterdam; five of the donors (5.4%) had a life-threatening disease. The aim of the present report is to give the rational and justification for this procedure. METHODS: All five donors underwent the national standard living-donor screening procedure. Additionally, motivation to donate and psychologic stability were assessed by a psychologist using in-depth interview techniques and a psychologic complaints questionnaire. Post-donor nephrectomy follow-up consis

Deciding to join a perinatal randomised controlled trial: experiences and views of pregnant women enroled in the Magpie Trial.

OBJECTIVE: to provide insight into pregnant women's experiences of participating in a large multi-centre randomised trial. DESIGN: qualitative semi-structured interviews. SETTING: six UK maternity units. PARTICIPANTS: women recruited to the Magpie Trial. The Magpie Trial was a trial of prophylactic anticonvulsants for women with severe pre-eclampsia. MEASUREMENTS FINDINGS: a number of major but related themes emerged regarding influences on the women's decision-making: unpredictability of pre-eclampsia; quality of information received; role of others in the decision-making process; perceive

Treatment of frontoethmoidal meningoencephalocele in Cambodia: a low-cost procedure for developing countries.

OBJECT: Frontoethmoidal meningoencephaloceles (MECs) are a relatively common abnormality in southeast Asia, with disastrous consequences for the sufferer. In Cambodia, a lack of skilled neuro- and craniofacial surgeons, and the cost of surgery limit the possibilities for appropriate treatment of patients with these lesions. The authors developed a low-cost humanitarian program with the goals of treating frontoethmoidal MECs, ensuring careful postoperative follow-up, and teaching Khmer surgeons how to treat these malformations. METHODS: This program was facilitated by two nongovernmental organ

A meta-synthesis of filicide classification systems: psychosocial and psychodynamic issues in women who kill their children.

Filicide is the killing of a child by a parent. To protect potential homicide victims, it is necessary to examine and identify intrapsychic and interpersonal dynamics that result in filicide. The current filicide classification systems have intended to yield better etiological understanding of the crime and ultimately lead to prevention strategies and accurate death certification. A framework of motives and precipitating factors that lead to filicide by mothers offers a starting point to examine this emotionally evocative and complex phenomenon.

Psychological care of caregivers, nurses and physicians: a study of a new approach.

There is much evidence demonstrating that psychosocial interventions in caregivers and oncological staff produce an improvement in their patients' quality of life. The aim of this explorative study was to evaluate the effect of a new approach in promoting more functional ways to face stressful situations in the constellation of people around patients: caregivers, physicians and nurses. Thirty-four subjects were divided into three groups: 10 caregivers, 11 physicians, and 13 nurses. A "Balint Group" method modified according to a mindfulness technique was used as the intervention. Three assessm

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… The only two mature mechanisms were altruism (80%) and intellectualization (70%) (Fig. 1 A). Figure 1 Estimated percentage of mature (A) and immature defenses (B) in the three groups, at baseline. … Altruism increased among physicians and nurses especially in solidarity and cooperation with the colleagues. By contrast, altruism remained stable in caregivers, due to its high value at baseline. …

Oocyte donors' motivations for donation and expectations about post-donation contact with donor-conceived individuals: a systematic review.

BACKGROUND: Oocyte donation has been increasingly used in ARTs in recent years. Previous reviews have generally reported positive donor atti … ectations towards future contact with donor-conceived offspring. Donors were primarily motivated by altruism and financial need, with varying motivations across different sociocultural contexts. Variations were observed in perspectives on anonymity, disclosure, and expectations about future contact, reflecting the influence of legal frameworks, cultural no …

How do study design features and participant characteristics influence willingness to participate in clinical trials? Results from a choice experiment.

BackgroundResearch about the decision to participate in a clinical study has tended to be limited to single indications and has focused on narrow sets of study and participant characteristics. This study applied stated preference methods to understand the clinical trial design attributes that most influence willingness to participate and how this varied with participant characteristics.MethodsAdults residing in the US, China, or Poland with a self-reported diagnosis of cancer, heart disease, migraine, rheumatoid arthritis, or multiple sclerosis completed an online survey. Participants were ask

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… Participants were considered to have high trust or high altruism if they rated their agreement as agree or strongly agree for each statement. … c , n (%) High altruism (agree/strongly agree) | 404 (83) Low altruism (disagree / strongly disagree) | 83 (17) Table 3 Clinical characteristics ( N = 487) a Not mutually exclusive. …

Ten Years of Kidney Paired Donation at Mayo Clinic: The Benefits of Incorporating ABO/HLA Compatible Pairs.

BACKGROUND: We examined the 10-year experience of Mayo Clinic's kidney paired donation (KPD).We aimed to determine the benefits for the recipients of enrolled ABO/HLA compatible pairs and determine the factors associated with prolonged KPD waiting time. METHODS: We performed a retrospective study of 332 kidney transplants facilitated by the Mayo 3-site KPD program from September 2007 to June 2018. RESULTS: The median (interquartile range) time from KPD entry to transplantation was 89 days (42-187 days). The factors independently associated with receiving a transplant >3 months after KPD entr

Ethical considerations surrounding the response to Ebola: the Spanish experience.

BACKGROUND: The recent Ebola virus disease (EVD) outbreak, with 28,646 reported cases and 11,323 deaths, was declared a public health emergency of international interest by the World Health Organisation. In Spain, a single reported case triggered a public health crisis of a markedly media-centred nature. The approach to the first EVD epidemic has given rise to various ethical considerations around the world. We address the most relevant ethical considerations emanating from the management of EVD in Spain. MAIN BODY: Firstly, for reasons of global justice and humanitarian assistance, rich coun

Donor insemination: Israel as a representative case of a competitive market examining the possibility of policy reform.

AIM: To measure the private and social benefits of donor insemination (DI). METHODS: An empirical model investigates the general public and DI clients' willingness to pay (WTP) for DI, and the willingness of potential donors to become altruistic or paid sperm donors. RESULTS: The general public and DI clients value DI and have a positive WTP for it, whereas willingness to donate, altruistically or for payment, is either low or very low. CONCLUSION: The general public's and DI clients' WTP for DI is in average above actual cost, so the government should consider funding or subsidizing DI. Th

Causes of organ donation failure in Brazil.

INTRODUCTION: There has been a great improvement in transplantation medicine in Brazil in the last 2 decades. However, there remain several barriers regarding notification of brain and cardiac death as well as completion of the donation process. METHODS: This retrospective study was performed between January 2008 and December 2010. We reviewed all deaths in a University Hospital, observing the causes of non-notification to the State Transplantation Authority and non-donations. RESULTS: There were 41 notifications of brain death resulting in donation in only 19.5% of those cases. Cardiac deat

Unconditional cash transfers for reducing poverty and vulnerabilities: effect on use of health services and health outcomes in low- and middle-income countries.

BACKGROUND: Unconditional cash transfers (UCTs; provided without obligation) for reducing poverty and vulnerabilities (e.g. orphanhood, old age or HIV infection) are a type of social protection intervention that addresses a key social determinant of health (income) in low- and middle-income countries (LMICs). The relative effectiveness of UCTs compared with conditional cash transfers (CCTs; provided so long as the recipient engages in prescribed behaviours such as using a health service or attending school) is unknown. OBJECTIVES: To assess the effects of UCTs for improving health services us

Medical students' knowledge and attitudes toward organ donation: results of a Dutch survey.

BACKGROUND: In the Netherlands, as in many other countries, a paucity of research exists on the attitudes and intentions of medical students toward organ donation. These students are of interest for the effect that increasing medical knowledge might have on the willingness to register as a donor. OBJECTIVE: To examine which factors determine medical students' willingness to register as donors. METHODS: We conducted a cross-sectional survey among medical students at the University of Amsterdam. Our questionnaire included questions on actual donor registration, motives, knowledge, and attitude

[The humanitarian work of France in the Sahara. The Health Service of the army in the territories of Southern Algeria (1900-1976].

Medical assistance to the Saharian populations (1900-1976) is viewed through its organization. The management of the Health Service in the Southern Territories, doctors, nursing staff, medical districts, centred on infirmary-hospitals and rural first-aid posts. We insist on the everrising free consultations and the care to sick and wounded patients in infirmaries; the fight against epidemics and social scourges. Then on French medical mission from 1963 to 1976, and on the humanitarian work by the Health Service throughout the five continents.

Deciding to Enrol in a Cancer Trial: A Systematic Review of Qualitative Studies.

BackgroundClinical trials are essential for the advancement of cancer treatments; however, participation by patients is suboptimal. Currently, there is a lack of synthesized qualitative review evidence on the patient experience of trial entry from which to further develop decision support. The aim of this review is to synthesise literature reporting experiences of participants when deciding to enrol in a cancer clinical trial in order to inform practice.MethodsA systematic review and meta-synthesis of qualitative studies were conducted to describe the experiences of adult cancer patients who d

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… The majority of participants believed that no one would participate in a trial solely due to altruism. … Altruism among participants in cancer clinical trials. Clin Trials . 2011;8(5):616–623. doi: 10.1177/1740774511414444 14. Shah A, Efstathiou JA, Paly JJ, et al. …