Suchergebnisse

Although training and use of multiple raters have been suggested to minimize demographic and individual biases on performance evaluations (Latham & Wexley, 1981), use of multiple raters often results in low interrater reliability which compounds the difficulty of establishing performance rating validity. The present study investigated the performance ratings made by the peers and supervisors of correction's officers, i.e., prison guards. Attention wasfocused on two issues: (1) the effects of rater and ratee personal, attitudinal, and relationship variables on performance ratings, and (2) examining performance "perspective differences" as an explanation of rating agreement. Results indicated that supervisor-subordinate educational similarity was significantly related to subordinate's performance rating. Supervisor-subordinate agreement on job dimension importance and subordinate age similarity with peer raters were also marginally related to performance ratings. The findings are discussed from the perspectives of shared cognitive schemas ofjob behaviors and practical implications.

Addictive drugs are responsible for mass killing. Neither persons with addiction nor the general populace seem conscious of the malevolence of governments and drug dealers working together. How could this be? What is the place of psychoanalysis in thinking about deaths from addiction and in responding to patients with addiction? To answer these questions, we revise concepts of SEEKING, drive, instinct, pleasure, and unpleasure as separable. We review the neurobiological mechanism of cathexis. We discuss how addictive drugs take over the will by changing the SEEKING system. We review how opioid tone in the central nervous system regulates human relationships and how this endogenous hormonal system is modified by external opioid administration. We differentiate the pleasure of relatedness from the unpleasure of urgent need including the urgent need for drugs. We show how addictive drug-induced changes in the SEEKING system diminish dopaminergic tone, reducing the motivation to engage in the pursuit of food, water, sex, sleep, and relationships in favor of addictive drugs. With this neuropsychoanalytic understanding of how drugs work, we become more confidently conscious of our ability to respond individually and socially.

Abstract
Objective To describe unique indications for covered stent grafts in trauma-associated cerebrovascular injuries.
Patients Between 2006 and 2018, five patients with cerebrovascular injuries were treated with a covered stent graft. We present a retrospective analysis of technique and outcomes.
Results In all cases stent deployment was successful. Endoleaks occurred in two cases requiring additional transvenous embolization of a carotid cavernous fistula (CCF) in one patient. Two cases of in-stent thrombosis were observed during intervention and 2 days postintervention in a patient with a long-segment dissection of the internal carotid artery (ICA) and another patient with a contained ICA rupture, both of which could not be prepared with dual antiplatelet therapy. Intravenous heparin and intra-arterial tirofiban dissolved in-stent thrombosis efficiently. One CCF and an iatrogenic vertebral artery injury were covered adequately with GraftMaster stent grafts.
Conclusion Patient selection with regard to individual anatomy and the site of vascular lesions is essential for an uncomplicated deployment of covered stent grafts and the success of therapy. Management of dual antiplatelet therapy, anticoagulation, and an escalation of medication in cases of in-stent thrombosis require expertise, a strict therapeutic regime, and an evaluation of individual risks in polytraumatized patients.