Forensic assessment of polycyclic aromatic hydrocarbons at the former Sydney Tar Ponds and surrounding environment using fingerprint techniques.

Polycyclic aromatic hydrocarbons (PAHs) were assessed spatially and temporally within and adjacent to a former coking and steel manufacturing facility in Sydney, Nova Scotia, Canada. Concentrations of PAHs were measured in surface soils, marine and estuary sediments prior to and during remediation of the Sydney Tar Ponds (STPs) site which was contaminated by nearly a century of coking and steel production. Previous studies identified PAHs in surficial marine sediments within Sydney Harbour, which were considered to be derived from STP discharges. Numerous PAH fingerprint techniques (diagnostic ratios, principal component analysis, quantitative and qualitative analysis) were applied to soil and sediment samples from the STPs and surrounding area to identify common source apportionment of PAHs. Results indicate coal combustion (from historical residential, commercial and industrial uses) and coal handling (from historic on-site stockpiling and current coal transfer and shipment facilities) are likely the principal source of PAHs found in urban soils and marine sediments, consistent with current and historical activities near these sites. However, PAH fingerprints associated with STP sediments correlated poorly with those of urban soils and marine sediments, but were similar to coal tar, historically consistent with by-products produced by the former coking operations. This study suggests PAH contamination of Sydney Harbour sediments and urban soils is largely unrelated to historic coking operations or recent remediation of the STPs site, but rather a legacy of extensive use of coal for a variety of activities.

Diagnostic challenges of primary thalamic gliomas-identification of a minimally enhancing neuroradiological subtype with aggressive neuropathology and poor clinical outcome.

AIM: To evaluate neuropathology and neuroradiology in the diagnosis and clinical outcome of a retrospective cohort of thalamic gliomas. METHODS: Neuropathological and neuroradiological review was undertaken in 25 cases of radiologically suspected thalamic glioma (excluding childhood pilocytic astrocytoma) over an 8 year period (2004-2012) at Frenchay Hospital and compared to the clinical outcome. RESULTS: In 12/25 (48%) there was a difference in neuropathological and suspected neuroradiological grading of the lesion of one or more grades. In 5/12 (42%) cases, the neuroradiology was lower grade than the pathology. In 4/5 (80%) of these cases, we identified a minimally enhancing subtype where the neuroradiology was predicted to be of lower grade than neuropathology. In 4/12, (33%) the suspected neuroradiology grade was higher than the final pathology. In 3/4, (75%) of these cases the suspected neuroradiology grade was higher than the neuropathology possibly because of unusual differentiation within the thalamic glioma (central neurocytoma, anaplastic oligoastrocytoma, and diffuse astrocytoma with pilocytic features). In 3/12 (25%) the biopsy was non-diagnostic. Neuropathology was a better predictor of clinical outcome than neuroradiology. 9/10 (90%) WHO Grade 4 gliomas and 8/9 (88%) Grade 3 gliomas on neuropathology were dead between 3-7 years after diagnosis. 3/3 (100%) Grade 2 gliomas on neuropathology were alive 3-7 years after diagnosis. 2/3 (67%) of the non-diagnostic cases were alive 3-7 years after biopsy. In 1/3 (33%) of the non-diagnostic cases the outcome was unknown. CONCLUSIONS: Diagnosis of primary thalamic glioma is challenging. We have identified that in the thalamus, a pattern of diffuse infiltration with minimal enhancement on imaging may often represent high-grade glioma. Neuropathology is overall the best predictor of clinical outcome.

Client interpersonal and cognitive styles as predictors of response to time-limited cognitive therapy for depression.

This study examined the relationship between cognitive and interpersonal styles and outcome among 24 clients who received time-limited cognitive therapy for depression. The authors hypothesized that this relationship would be mediated by therapeutic alliance. They found that clients' interpersonal style, particularly an underinvolved style, was predictive of treatment outcome. As predicted, the impact of this style on outcome was mediated through the therapeutic alliance.

DSM-III in the training of British psychiatrists: a national survey.

All 223 psychiatric clinical tutors in the UK were surveyed on their use of DSM-III in their postgraduate training programmes. Results indicate that DSM-III is widely used in clinical training to some extent in the majority of schemes (73%) and in the schemes where it is used it is rated as moderately useful by nearly everyone (93%). DSM-III is generally perceived to have positive effects on learning basic elements of psychopathology and in offering a common language for diagnostic discussion. Interestingly only 16% of users felt that DSM-III was so complicated that it impeded rather than facilitated the teaching of diagnosis. Few schemes provide specific teaching courses and case conferences provide the major forum for teaching DSM-III.

The use of the term 'borderline patient' by Scottish psychiatrists: II. Conceptual and descriptive analysis.

A descriptive and conceptual analysis of the use of the term 'borderline patient' by Scottish psychiatrists revealed that they view borderline patients as being near the psychotic end of the illness spectrum, with a marked propensity towards brief, reactive, reversible, paranoid or schizophrenic reactions. There is clear evidence that the term is not used to refer to patients who in the United States would be labelled borderline schizophrenic. Individual American diagnostic schemata would omit features held to be of major importance by Scottish psychiatrists when diagnosing borderline patients. In an earlier study, Macaskill and Macaskill (1981) found that the term 'borderline patient' although not in the official nomenclature, was used by over one in four Scottish psychiatrists to delineate a syndrome which they felt should be included in contemporary diagnostic systems because of its prognostic and therapeutic implications. This study provided the first demographic information on the use of the term in the United Kingdom, but did not permit direct comparisons at conceptual and descriptive levels with studies in the United States where the term is widely used and recognised in the official nomenclature of the American Psychiatric Association's Diagnostic and Statistical Manual--III (1980). Research into the use of the term schizophrenia, for example by Cooper et al (1972), has shown that major differences in usage between the United Kingdom and the United States have occurred with serious implications for the cross-cultural validity of research findings in schizophrenia.(ABSTRACT TRUNCATED AT 250 WORDS)

The theory of transitional phenomena and its application to the psychotherapy of the borderline patient.

Winnicott's theory of transitional phenomena is outlined and the various meanings of the term transitional phenomena are indicated. The psychotherapeutic applications of his theory to the treatment of borderline patients, particularly the implications for the functions, language and timing of verbal interventions are then explored. Finally, his ideas are briefly compared with those of other therapists currently influential in the theory and therapy of borderline patients.

The use of the term 'borderline patient' by Scottish psychiatrists: a preliminary survey.

One hundred and sixty Scottish psychiatrists complete a questionnaire eliciting the extent of their use of the term 'borderline patient' and the factors affecting this. The term was used by 27.5 per cent, the majority of whom felt that it ought to be included in current diagnostic classification systems. There was, however, general dissatisfaction with the vagueness of current definitions of the term and a confusing use of numerous diagnostic labels. Use of the term was not related to status, geographical location, or familiarity with American psychiatric literature. The practice of psychodynamically-oriented psychotherapy and extended working contact with psychiatry in North America were found significantly to increase its use.

The narcissistic core as a focus in the group therapy of the borderline patient.

An approach to the group psychotherapy of the hospitalized borderline patient is described. Drawing on recent formulations of the narcissistic constellation in these patients a focal interpretative approach is used emphasizing the defensive nature of the chronic rage, devaluation and self-interest of these patients. This allows the beginnings of group cohesiveness to be established based on shared hurt and damaged self-image, and facilitates the utilization of the various treatment modalities which are necessary in the long-term treatment of this group. These issues are illustrated with examples drawn from group sessions.