A web-survey assessed attitudes toward evidence-based practice among psychotherapists in Austria.

Evidence-based practice (EBP) means integrating the best available scientific evidence with clinical experience and patient values. Although perceived as important by many psychotherapists, there still seems to be reluctance to use empirically supported therapies in clinical practice. We aimed to assess the attitudes of psychotherapists in Austria toward EBP in psychotherapy as well as factors influencing the implementation of EBP. We conducted an online survey. To investigate attitudes toward EBP, we used two subscales ("Limitations" and "Balance") of a translated and validated short version of the Evidence-Based Practice Attitude Scale-36 (EBPAS-36). Participants provided perceived barriers and facilitators as answers to open-ended questions. We analyzed the responses mainly using descriptive statistics. Open answers were analyzed using a thematic analysis. In total, 238 psychotherapists completed our survey (mean age 51.0 years, standard deviation [SD] = 9.9, 76.9% female). Psychotherapists scored on average 2.62 (SD = 0.89) on the reversed EBPAS-36 subscale "Limitations," indicating that the majority do not perceive EBP as limiting their practice as psychotherapists. They scored 1.43 (SD = 0.69) on the reversed EBPAS-36 subscale "Balance," indicating that psychotherapists on average put a higher value on the art of psychotherapy than on evidence-based approaches. Organizational factors such as lack of time and access to research studies as well as negative attitudes toward research and a lack of skills and knowledge kept respondents from implementing EBP. Our study highlights that EBP is still not very popular within the psychotherapy community in Austria. The academization of psychotherapy training might change this in the future.

[Clinical aspects of image quality and doses in gated pulsed imaging]. / Klinische Aspekte zu Bildqualität und Dosis bei gittergesteuerter gepulster Durchleuchtung.

PURPOSE: The relations between image quality in last image hold images and dose in grid controlled fluoroscopy in comparison to the continuous mode need to be characterised and recommendations for the clinical application of this technique should be given. MATERIAL AND METHODS: Spatial resolution, signal-noise ratio and, contrast-detail visibility were evaluated by phantom measurements in grid controlled pulsed and continuous fluoroscopy. Dose was measured at the image intensifier entrance. Image quality of last image hold (LIH) images of clinical examinations was graded in relation to single shot exposures. RESULTS: Signal-noise ratio and contrast-detail visibility depend on the dose per puls. Spatial resolution and contrast-detail visibility in grid controlled fluoroscopy are superior than to in the continuous mode. Image quality of the LIH images from the grid controlled fluoroscopy was improved. Radiation exposure could be reduced to 10-46%. CONCLUSIONS: Combinations of puls-dose and -frequency are recommended for achieving extensive dose reduction and improved image quality of LIH images.

[Studies of image quality and dose in digital subtraction angiography]. / Untersuchungen zu Bildqualität und Dosis bei der DSA.

METHODS: The dose needed for high image quality in l.a. DSA, was determined by investigation of the necessary relationship between dose and image quality. This method is based on measurements of the signal-to-noise ratio and of the contrast-detail detectability. It has been tested on two different systems (Philips integris V3000, Philips Diagnost 97). RESULTS: Our measurements prove that an image intensifier entrance dose of 1.1 microGy (image intensifier diameter 38 cm) is sufficient for high image quality in DSA. An increased dose value does not lead to an improvement in image information. For details larger than the pixel size the 512 matrix produces a higher signal-to-noise ratio with a higher contrast-detail detectability, whereas higher spatial resolution results by the use of a 1024 matrix. In rotational angiography, high image quality can be achieved at an image intensifier entrance dose of 1.1 microGy. In contrast to sequences without rotation, image quality is decreased through movement unsharpness. As the maximum exposure time 25 ms should be selected. The use of a 1024 matrix does not lead to a better spatial resolution in rotational angiography.

Leigh's disease with clinical manifestations of Cornelia de Lange syndrome.

Leigh's disease was found postmortem in a 5-year-old girl who was diagnosed clinically as Cornelia de Lange syndrome at age 1 year. The child's neurological status began to deteriorate rapidly at age 4.5 years and she died suddenly 6 months later. Postmortem examination of the brain revealed bilateral necrosis of the hypothalamus, subthalamic nuclei, midbrain, pons, and medulla. Previous studies have linked Cornelia de Lange syndrome to hypothalamic lesions. This case demonstrates that Leigh's disease, which also damages the hypothalamus, could present with phenotypic features of Cornelia de Lange syndrome.

[Determination of normal values by means of various statistical methods derived from radioiodine tests (author's transl)]. / Ermittlung von Normalbereichen mit verschiedenen statistischen Verfahren beim Radiojod-Test

Normal values derived from 361 euthyroid patients were calculated by means of five different statistical methods and compared. Borderline values were also obtained from 61 patients with hyperthyroidism, nine with hypothyroidism and ten with autonomous adenomas. The following individuals data were collected: 131 I-PBI after 48 hours, thyroid uptake after two, 24 and 48 hours.