SynopsisFifty-seven chronic agoraphobic outpatients were treated by 12 hours of exposure in vivo on four days over two weeks to check the effects of oral diazepam versus placebo during group exposure, group versus individual exposure, and high versus medium anxiety arousal during individual exposure. The controlled parallel design allowed comparative evaluation of each treatment condition to six months follow-up. Assessment was blind with respect to drug and psychological treatment. Patients in all treatment conditions improved significantly in phobias and in related life areas.Outcome to group exposure on phobias and other measures was similar in all three drug conditions (placebo, waning diazepam, peak diazepam) with no significant differences between them. Diazepam patients had significantly less discomfort than placebo patients during group exposure treatment. Group exposure patients improved slightly but significantly more than individual exposure patients on non-phobic measures, though group exposure was accompanied by more panics during treatment yet was easier to run by the therapist. Individual exposure under high anxiety arousal was no more therapeutic than with lower anxiety. Diazepam is a mild palliative during group exposure but does not facilitate outcome to treatment. Group exposure in vivo is mildly facilitatory for outcome compared with individual exposure. Anxiety evocation during treatment was not therapeutically helpful.

Detrusor instability has remained resistant to conventional forms of treatment. An attempt to use biofeedback methods in its management is described. Six female patients with symptoms of frequency, urgency and urge incontinence due to detrusor instability were conditioned to auditory and visual stimuli for 6 to 8 1 h sessions. They were assessed clinically and urodynamically. The results are presented as well as detailed case studies of 3 patients. Subjectively, 3 were cured, 2 improved and 1 remained the same; objectively, 3 were cured, 1 improved and 2 remained the same. No significant side effects were encountered.

Fifty-one second-year students completed the Attitudes to Treatment Questionnaire (ATQ), the Conservatism Scale (CS), the Defence Style Questionnaire (DSQ) and an open-ended questionnaire before and after components of their psychiatric training programme, which included a 1-week placement in a psychiatric hospital. CS scores indicated that the nurses were moderately conservative. ATQ scores and CS scores correlated significantly, with the more conservative nurses reporting more traditional attitudes to psychiatric nursing. ATQ scores fell significantly after psychiatric hospital placement, indicating more progressive attitudes. Mean scores on the DSQ were within normal limits, although men scored significantly higher than women on the Immature Defences Scale immediately after placement. The open-ended questionnaire revealed mainly positive comments about the psychiatric hospital placement. Almost half the nurses expressed surprise at the relaxed, informal atmosphere on the wards, and as many stated that personal interaction with the patients rapidly removed any stereotyped attitudes that they held previously. Over 40% of nurses stated that the patients were much less aggressive or dangerous than they had expected, although nearly 20% said they were concerned about the levels of aggression that they observed.

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Adapted vehicle control systems can reduce the stresses and damage, the machine downtime and consequently the operating and maintenance costs of mobile machines. Researchers of the Karlsruhe Institute of Technology (KIT) have therefore developed a method for real-time load determination using the example of a wheel loader boom.