Bion's Notes on memory and desire – its initial clinical reception in the United States: A note on archival material

While Bion's 1967 memory and desire paper reflected a crucial episode in his clinical thinking during his epistemological period, it was also central to his evolution as a Kleinian psychoanalyst who worked with seriously disturbed adult patients. The author explicates and contextualizes these claims with a new archival document, the Los Angeles Seminars delivered by Bion in April 1967, and the full‐length version of Notes on memory and desire. Bion here instigated a radical departure from years of theory‐laden work when he made his clinical work and ideas accessible to a new audience of American Freudian analysts. While this new group was keenly interested to hear about Bion's clinical technique with both borderline and psychotic patients, there were varied reactions to Bion's ideas on the technical implications of the analyst's abandonment of memory and desire. Both the Los Angeles Seminars and Notes elicited responses ranging from bewilderment, admiration to skepticism amongst his audience of listeners and readers. These materials also however allow for a more complete and systematic presentation of important ideas about analytic technique – and while his ideas in this domain have been long valued and known by many psychoanalysts, this contribution stresses the crucial aspect of the reception of his ideas about technique in a particular American context. American analysts gained a much more explicit idea of how Bion worked analytically, how he listened, formulated interpretations and factored in the analyst's listening receptivity in the here‐and‐now. The author concludes with a consideration of the importance of Bion's American reception in 1967.     

Color Selectivity of the Spatial Congruency Effect: Evidence from the Focused Attention Paradigm

The multisensory response enhancement (MRE), occurring when the response to a visual target integrated with a spatially congruent sound is stronger than the response to the visual target alone, is believed to be mediated by the superior colliculus (SC) (Stein & Meredith, 1993). Here, we used a focused attention paradigm to show that the spatial congruency effect occurs with red (SC-effective) but not blue (SC-ineffective) visual stimuli, when presented with spatially congruent sounds. To isolate the chromatic component of SC-ineffective targets and to demonstrate the selectivity of the spatial congruency effect we used the random luminance modulation technique (Experiment 1) and the tritanopic technique (Experiment 2). Our results indicate that the spatial congruency effect does not require the distribution of attention over different sensory modalities and provide correlational evidence that the SC mediates the effect.     

ANALYTIC MIND USE AND INTERPSYCHIC COMMUNICATION: DRIVING FORCE IN ANALYTIC TECHNIQUE,PATHWAY TO UNCONSCIOUS MENTAL LIFE

Developed from established psychoanalytic knowledge among different psychoanalytic cultures concerning unconscious interpsychic communication, analysts' use of their receptive mental experience—their analytic mind use, including the somatic, unconscious, and less accessible derivatives—represents a significant investigative road to patients' unconscious mental life, particularly with poorly symbolized mental states. The author expands upon this tradition, exploring what happens when patients unconsciously experience and identify with the analyst's psychic functioning. The technical implications of the analyst's “instrument” are described, including the analyst's ego regression, creation of inner space, taking mind as object, bearing uncertainty and intense affect, and self‐analysis. Brief case vignettes illustrate the structure and obstacles to this work.     

治疗感染性骨不连伴大段骨缺损的探讨与思考

感染性骨不连伴大段骨缺损是目前临床骨科较为常见、多发、治疗极为棘手的病种之一,治疗方法多种多样,但疗效却不理想,且缺乏统一的诊治与疗效判断标准,总结、分析几种临床上主要治疗方法的利弊,为该病探寻一条微创、安全、并发症少及疗效确切的可靠治疗方法.随着对Ilizarov技术的基础与临床研究的不断深入,该技术在治疗传统方法难以治愈的疾病如四肢关节严重畸形、感染性骨不连或伴有骨缺损、皮肤软组织缺损等方面显示出自身的优势,为治疗疑难骨科疾病开辟了一条新的有效途径.     

肢体自然重建理念——一种人文关怀治疗

著名的医学家、哲学家Hippocrates在公元前4世纪就指出:医生的责任仅在于促进疾病的自然康复过程,而非阻拦这个过程.患者得以治愈的根据是患者自身存在的康复能力;医生首先必须清楚:自己所治疗的对象是人,是有生命的、有思想的、活在社会上的人,而不是被修理的物件.医生能够做到的只是为患者创造或提供一定的有利于康复的条件.20世纪50年代,前苏联骨科专家Ilizarov发现了张力-应力法则,并因此创造出的牵拉再生、自然重建技术,正是很好地诠释了Hippocrates的思想.     

Investigating cycling kinematics and braking maneuvers in the real world: e-bikes make cyclists move faster,brake harder,and experience new conflicts

Pedelecs (e-bikes), which facilitate higher speeds with less effort in comparison to traditional bicycles (t-bikes), have grown considerably in popularity in recent years. Despite the large expansion of this new transportation mode, little is known about the behavior of e-cyclists, or whether cycling an e-bike increases crash risk and the likelihood of conflicts with other road users, compared to cycling on t-bikes. In order to support the design of safety measures and to maximize the benefits of e-bike use, it is critical to investigate the real-world behavior of riders as a result of switching from t-bikes to e-bikes.Naturalistic studies provide an unequaled method for investigating rider cycling behavior and bicycle kinematics in the real world in which the cyclist regularly experiences traffic conflicts and may need to perform avoidance maneuvers, such as hard braking, to avoid crashing. In this paper we investigate cycling kinematics and braking events from naturalistic data to determine the extent to which cyclist behavior changes as a result of transferring from t-bikes to e-bikes, and whether such change influences cycling safety.Data from the BikeSAFE and E-bikeSAFE naturalistic studies were used in this investigation to evaluate possible changes in the behavior of six cyclists riding t-bikes in the first study and e-bikes in the second one. Individual cyclists’ kinematics were compared between bicycle types. In addition, a total of 5092 braking events were automatically extracted after identification of dynamic triggers. The 286 harshest braking events (136 cases for t-bike and 150 for e-bike) were then validated and coded via video inspection.Results revealed that each of the cyclists rode faster on the e-bike than on the t-bike, increasing his/her average speed by 2.9–5.0 km/h. Riding an e-bike also increased the probability to unexpectedly have to brake hard (odds ratio = 1.72). In addition, the risk of confronting abrupt braking and sharp deceleration were higher when riding an e-bike than when riding a t-bike.Our findings provide evidence that cyclists’ behavior and the way cyclists interact with other road users change when cyclists switch from t-bikes to e-bikes. Because of the higher velocity, when on e-bikes, cyclists appear to have harder time predicting movements within the traffic environment and, as a result, they need to brake abruptly more often to avoid collisions, compared with cycling on t-bikes. This study provides new insights into the potential impact on safety that a cycling society moving to e-bikes may have, indicating that e-cycling requires more reactive maneuvers than does cycling traditional bicycles and suggesting that any distractive activity may be more critical when riding e-bikes compared to traditional bikes.     

Testing autocorrelation and partial autocorrelation: Asymptotic methods versus resampling techniques

Autocorrelation and partial autocorrelation, which provide a mathematical tool to understand repeating patterns in time series data, are often used to facilitate the identification of model orders of time series models (e.g., moving average and autoregressive models). Asymptotic methods for testing autocorrelation and partial autocorrelation such as the 1/T approximation method and the Bartlett's formula method may fail in finite samples and are vulnerable to non-normality. Resampling techniques such as the moving block bootstrap and the surrogate data method are competitive alternatives. In this study, we use a Monte Carlo simulation study and a real data example to compare asymptotic methods with the aforementioned resampling techniques. For each resampling technique, we consider both the percentile method and the bias-corrected and accelerated method for interval construction. Simulation results show that the surrogate data method with percentile intervals yields better performance than the other methods. An R package pautocorr is used to carry out tests evaluated in this study.     

Panning for the gold in health research: Incorporating studies’ methodological quality in meta-analysis

Background: Systematic reviews now routinely assess methodological quality to gauge the validity of the included studies and of the synthesis as a whole. Although trends from higher quality studies should be clearer, it is uncertain how often meta-analyses incorporate methodological quality in models of study results either as predictors, or, more interestingly, in interactions with theoretical moderators.

Objective and methods: We survey 200 meta-analyses in three health promotion domains to examine when and how meta-analyses incorporate methodological quality.

Results: Although methodological quality assessments commonly appear in contemporary meta-analyses (usually as scales), they are rarely incorporated in analyses, and still more rarely analysed in interaction with theoretical determinants of the success of health promotions. The few meta-analyses (2.5%) that did include such an interaction analysis showed that moderator results remained significant in higher quality studies or were present only among higher quality studies. We describe how to model quality interactively with theoretically derived moderators and discuss strengths and weaknesses of this approach and in relation to current meta-analytic practice.

Conclusions: In large literatures exhibiting heterogeneous effects, meta-analyses can incorporate methodological quality and generate conclusions that enable greater confidence not only about the substantive phenomenon but also about the role that methodological quality itself plays.