Sixty-eight patients suffering from generalized anxiety disorder were allocated to one of four groups to study how hypnotizability (high versus low) and type of suggestion (direct versus indirect) were related to treatment outcome. Patients were assessed on three occasions (Pre-treatment; Post-treatment; and three month Follow-up) using seven anxiety measures and one depression inventory. The Creative Imagination Scale (CIS) was used to assess susceptibility to hypnotic responding. Twenty Ss dropped out prematurely due to both practical and treatment related issues. Interestingly, dropouts were also found to have been significantly more depressed than completers. Patients were given six treatment sessions of hypnotherapy at weekly intervals while the author remained blind to CIS scores. Therapy focused on accessing S's unconscious abilities and resources for symptom resolution, using either direct or indirect suggestion. Patients were provided with self-hypnosis tapes for anxiety reduction in between appointments. Results indicated that completers significantly improved on all dependent measures, but few differences emerged between the four groups. Interestingly, highly hypnotizable patients who received indirect suggestion relapsed slightly on all measures by the Follow-up period, having improved from Pre- to Post-treatment. Discussion is offered on the possible implications these results have for the integrity of the independent variables, concluding that both hypnotizability and type of suggestion have a clinically significant interactive effect. Direct suggestion is recommended for highly hypnotizable generalized anxiety disorder clients, while both direct and indirect suggestion can be used with low hypnotizables, as long as all are couched within permissive language. Limitations of the present research are discussed, along with recommendations for clinical practice and future research

The effect of heat treatment of milk on whey proteins, sulphydryl (reactive and total), disulphide groups, half cystine, volatile sulphur compounds and sensory properties was studied in order to relate changes in the flavour of milks to changes in chemical composition. The degree of heat denaturation of whey proteins increased generally in the following order: HTST treatment, direct UHT treatment, indirect UHT treatment, and the severest was laboratory heat treatment where milks were held at temperatures below 1000 C for several minutes. At the same heating temperature and holding time indirect UHT treatment was found to result in more whey protein denaturation compared with direct UHT treatment. The sensitivity of whey proteins to denaturation was confirmed to be In decreasing order: serum albumin, S-lactoglobulin B, S-lactoglobulin A and a-lactalbumin. Laboratory heat treatment resulted in a peak of reactive sulphydryl groups, followed by a decrease, as the heating time is prolonged. HTST treatment and UHT treatments (direct and indirect) increased reactive sulphydryl groups from nearly zero in raw milk to values dependent on the heating temperature. Generally, heat treatment caused a decrease in concentration of total sulphydryl groups, disulphide groups and half cystine. Hydrogen sulphide and dimethyl sulphide were identified in heat-treated milks. Dimethyl sulphide was found to be present in raw milk as well as in heat treated milks. The increase in concentration of each of the volatile sulphur compounds was found to parallel the intensity of heating to the extent that they appeared to be linearly related. Volatile sulphur compounds decreased rapidly during storage at 22°C compared with~slower decrease during storage at 4oC. The panel was unable to detect differences between direct UHT milk and pasteurised milk. On the other hand, most panelists could detect differences between indirect UHT milk and pasteurised milk. The panelists were not able to distinguish between milks processed, respectively, at 77oc, 830 C and 890 C for 20 seconds using HTST treatment. A significant number of correct judgments w~s observed Wl+~ 940 C milk. The statements describing the difference were: heated taste, strong flavour, sulphurous, burnt flavour and very pronounced cooked flavour. All these statements are related to the cooked flavour. A good linear correlation was clearly observed between reactive sulphydryl groups and the whey proteins very sensitive to heat treatment, eg S-lactoglobulin A, S-lactoglobulin B and serum albumin. There was also a good linear correlation between reactive sulphydryl groups and mean whey protein denaturation. It was found that hydrogen sulphide concentration increased with increasing concentration of reactive sulphydryl groups, and with decreasing concentration of total sulphydryl groups, disulphide groups and half cystine respectively. There was also a good correlation between hydrogen sulphide and S-lactoglobulin A, S-lactoglobulin B and serum albumin. The degree of cooked flavour, the degree of whey protein denaturation, the concentration of reactive sulphydryl groups, the concentration of half cystine and the concentration of hydrogen sulphide show good correlation and similar dependence upon the severity of heat treatment. The data also suggest that the cooked flavour threshold corresponds to: a) 59 per cent denaturation of S-lactoglobulin (A + B); b) reactive sulphydryl group concentration of 0.037 mmole per litre of milk; c) half-cystine concentration of 1.082 mmole per litre of milk; d) hydrogen sulphide concentration of 3.4~g per litre of milk.

This master’s report collected the available literature regarding the multiple treatment approaches for oropharyngeal dysphagia and the efficacy of each approach in the remediation of swallowing deficits. A variety of traditional intervention techniques are described and their efficacy data is presented, as well as limitations and contraindications to intervention. Efficacy data for modern oropharyngeal dysphagia intervention techniques such as Vitalstim and E-stim is also presented, and the differences between the two techniques are discussed. Ethical decision-making in dysphagia treatment is also discussed. / text

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

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This study examines the relationship between attitude and outcome of 30 schizophrenic outpatients. Attitude is measured using the modes of response to psychosis proposed by MayerGross in 1920 and operationalised into questionnaire form by Soskis and Bowers (1969) and McGlashan and Carpenter (1981). The outcome is defined by the number ofrehospitalizations since the first diagnosis of schizophrenia. Results show a significant relationship between attitude and outcome. Positive attitude toward the illness and positive attitude toward the future were both significantly correlated with a positive outcome (lower rate of rehospitalization). Similarly, both negative attitudes toward the illness and negative attitude toward the future were significantly correlated with a negative outcome (higher rate of rehospitalization). There was a stronger correlation between positive attitudes and positive outcome than between negative attitudes and negative outcome. The relationship between attitude and outcome in schizophrenia is used to suggest alternative ways of conceptualizing and managing the condition. The findings of this study are also used to develop recommendations for further research. / Thesis (M.Soc.Sc.)-University of Natal, Pietermaritzburg, 1999.

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