On patients who explode: surviving petrifying psychotherapeutic experiences

Although most of our patients will enter the consulting room quite quietly, often in a depressive state, having contained their sadistic impulses, a tiny fraction of those with whom we work will attack us in a variety of chilling ways. In this article, the author describes in detail two particularly terrifying clinical experiences in which a patient either threatened to kill him or actually sullied his consulting room with bodily fluids. Drawing upon his psychotherapeutic encounters not only with intellectually disabled patients and forensic patients but, also, with those who presented as ordinary “normal-neurotics”, the author considers the phenomenology of these “bomb”-like explosions and explains how he attempted to maintain a classical psychoanalytical focus of understanding, which consisted of a careful scrutiny of the countertransference and a firm commitment to the interpretation of unconscious material, whilst under attack. Furthermore, he examines the essential role of speaking with experienced colleagues who will provide essential supervision or assistance during these challenging chapters of clinical practice. The author also considers the many ways in which “bombs” can be hurled not only by the more obviously dangerous or disturbed individuals but, also, with surprising frequency, by those with no criminal history whatsoever, who, upon first encounter, often present as reasonably healthy.

Comparison of Keyword Search Techniques with Respect to Electronic Health Records

As the world progresses towards automation, manual search for data from large databases also needs to keep pace. When the database includes health data, even minute aspects need careful scrutiny. Keyword search techniques are helpful in extracting data from large databases. There are two keyword search techniques: Exact and Approximate. When the user wants to search through EHR, a short search time is expected. To this end, this work investigates Metaphone (Exact search) and Similar_Text (approximate search) Techniques. We have applied keyword search to the data, which includes the symptoms and names of medicines. Our results indicate that the search time for Similar_text is better than for Metaphone.

A study of the efficacy of flame electrical resistance for standoff measurements during the oxyfuel cutting process

This is a study of the suitability of preheat flame electrical resistance as a potential method for measuring the standoff distance an oxyfuel cutting torch and a work piece. Careful scrutiny of forty seven (47) individual experiments demonstrate that when cut quality is good, there is a linear repeatable relationship between the two with uncertainty about ± .3mm (.015in). As the cut quality degrades, the formation of top-edge dross reduces the electrical path length in the flame, and momentary reduction in the reaction rate in the kerf reduces the free electrons in the flame, causing rises in flame resistance. In these conditions, measurement uncertainty reduces to ± 1mm (.040in) or worse.

Journal lists in social sciences and the spectrum of quality standards

The social sciences involve multiple literatures, including journals with a more international and those with a more local orientation. Quality standards in research assessment have largely been borrowed from STEM fields and generally favour internationally oriented journals with high international visibility and scientific impact, to the detriment of other quality dimensions, such as relevance to local communities and researchers or openness of research.In journal lists, this complex spectrum of quality standards is simplified into a one-dimensional arrangement. We provide a typology to characterize journal lists and discuss the usage of journal lists in research assessment, arguing that their values and criteria deserve careful scrutiny and can be studied through systematic comparison.

The EU in multilateral environmental compliance mechanisms: an outside view

With reference to its unique characteristics, the European Union (EU) regularly requests a special position in treaty cooperation or external judicial control mechanisms. Recurrently, these requests are successful and lead to the EU being treated differently from other treaty parties. These situations have been captured by the concept of ‘European exceptionalism’. EU requests for special treatment can also be witnessed in the supportive and facilitative procedures of compliance mechanisms in international environmental law. In those mechanisms, however, EU requests for special treatment are subject to careful scrutiny, and are even met with strong opposition by treaty institutions and treaty partners. Taking a closer look at the EU’s participation in compliance mechanisms, the present article discusses how certain unique EU characteristics may prompt an EU request for special treatment under compliance mechanisms and explores how compliance institutions and treaty partners have treated existing requests so far. With this outside perspective of non-EU actors, it is possible to understand where such requests can be successful and where they fail to be. In this way, the insights gained permit reflection upon the EU’s participation in compliance mechanisms and whether it truly constitutes a further phenomenon of ‘European exceptionalism’.

The Lindbladian form and the reincarnation of Felix Bloch's generalized theory of relaxation

The relationship between the classic magnetic resonance density matrix relaxation theories of Bloch and Hubbard and the modern Lindbladian master equation methods are explored. These classic theories are in full agreement with the latest results obtained by the modern methods. A careful scrutiny shows that this also holds true for Redfield's later treatment, offered in 1965. The early contributions of Bloch and Hubbard to rotating-frame relaxation theory are also highlighted. Taken together, these seminal efforts of Bloch and Hubbard can enjoy a new birth of contemporary relevance in magnetic resonance.

JUDICIAL RECOGNITION OF THE APPLICATION OF THE MAXIM RES IPSA LOQUITUR TO A CASE OF MEDICAL NEGLIGENCE Lungile Ntsele v MEC for Health, Gauteng Provincial Government (unreported as yet, Case Number: 2009/52394 (GSJ) dated 24 October 2012)

It is trite law, in context of medical negligence, that the onus of establishing civil liability on the doctor’s part lies with the patient and liability must be established on a preponderance of probabilities. It is to be noted that, should the plaintiff be unable to prove his/her case on a preponderance of probabilities, judgment will be given in favour of the defendant; a court may, however, also order absolution fromthe instance. In delict, the plaintiff bears the onus to prove a wrongful act/omission on the part of the physician, as well as the element of fault (in the form of negligence) and that the act or omission caused him to suffer damages or personal injury. Where a defendant raises a special defence such as consent, contributory negligence or prescription, the onus of proof will be on the defendant. Generally, however, the application of the maxim of res ipsa loquitur is treated by the courts as a particular form of inferential reason, requiring careful scrutiny and giving rise to an inference of negligence rather than a presumption of negligence. The South African courts thus far have been reluctant to apply the maxim to cases of medical negligence, despite persuasive legal arguments that have been put forward that the maxim should be applied in specific circumstances with regard to the proof of medical negligence. In this respect general principles for the effective application of the maxim in cases of medical negligence, are, inter alia, that principles of procedural equality and constitutional considerations dictate that the maxim be applied in cases of medical negligence. It is for this reason that the present judgment under discussion (in tandem with s 27 of the Constitution) is instructive, despite the majority judgment of the Appellate Division (as it wasthen) in 1924, in Van Wyk v Lewis (supra), where it was held that the maxim does not find application in cases of medical negligence.

Rousseau’s General Will

The advance of populist parties in the European Union can be interpreted as the sign of an expanding “frustration” about representation in a political sphere oppressed by economic austerity. In this context, the modern philosophical roots of an alternative conception of democracy, based on direct participation, appear to be worth of a careful scrutiny. This paper focuses on the notion of the General Will as described in The Social Contract. After a critical review of the antithetical conceptions of the General Will suggested by Rousseau, a coherent interpretation is proposed, obtained through an analysis of the text taken as a “self- -sufficient” unity: the General Will is pure “ambition” for an unknown common good, shared by all the members of a political community. However, it is argued that the participatory “machinery” of General Will is fundamentally incapable of resolving three serious problems that undermine the foundations of Rousseau’s ideal “République”, namely, 1. How the citizens can identify the common good without errors; 2. How the citizens can develop an ethical dimension by themselves, without any external influence; 3. How single individuals, seen not as active citizens but as passive subjects of the State, can protect themselves from the abuses of power.

A Study of the Efficacy of Flame Electrical Resistance for Standoff Measurements During the Oxyfuel Cutting Process

This is a study of the suitability of preheat flame electrical resistance as a potential method for measuring the standoff distance an oxyfuel cutting torch and a work piece. Careful scrutiny of forty seven (47) individual experiments demonstrate that when cut quality is good, there is a linear repeatable relationship between the two with uncertainty about ± .3mm (.015in). As the cut quality degrades, the formation of top-edge dross reduces the electrical path length in the flame, and momentary reduction in the reaction rate in the kerf reduces the free electrons in the flame, causing rises in flame resistance. In these conditions, measurement uncertainty reduces to ± 1mm (.040in) or worse.

Digital Contact Tracing Against COVID-19 in Europe: Current Features and Ongoing Developments

The SARS-CoV-2 pandemic is a public health challenge of unprecedented scale. In the midst of the first wave of the pandemic, governments worldwide introduced digital contact tracing systems as part of a strategy to contain the spread of the virus. In Europe, after intense discussion about privacy-related risks involving policymakers, technology experts, information technology companies, and—albeit to a limited extent—the public at large, technical protocols were created to support the development of privacy-compatible proximity tracing apps. However, as the second wave of SARS-CoV-2 sweeps the continent, digital contact tracing in Europe is evolving in terms of both technological and governance features. To enable policymakers to harness the full potential of digital health tools against SARS-CoV-2, this paper examines the evolution of digital contact tracing in eight European countries. Our study highlights that while privacy and data protection are at the core of contact tracing apps in Europe, countries differ in their technical protocols, and in their capacity to utilize collected data beyond proximity tracing alone. In particular, the most recently released apps tend to offer users more granular information about risk in specific locations, and to collect data about user whereabouts, in order to enhance retrospective contact tracing capacity. These developments signal a shift from a strict interpretation of data minimization and purpose limitation toward a more expansive approach to digital contact tracing in Europe, calling for careful scrutiny and appropriate oversight.