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The End of Programming as We Know It . . . . . . . . . . . . . . . . . . . . . . . . . 757 The ugly truth about data munging . . . . . . . . . . . . . . . . . . . . . . . . 757 Brutal simplicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 758



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At the top of this framework is psychoanalytic metapsychology the complex network of theoretical concepts and propositions that form the infrastructure of psychoanalysis Metapsychological terms are often abstract, rarely operationalizable, and typically used in dialogue with other theorists and practitioners The concepts of libido and selfobject are examples of language most closely associated with psychoanalytic metapsychology The middle-level language of psychoanalysis incorporates the constructs used by theorists and practitioners in their own day-to-day work It is the language in which psychoanalysts conceptualize problems and communicate informally the kind of language likely to turn up in the heart of a case study or in a set of clinical notes The terms oral dependent and sublimation are examples of the middle-level language of psychoanalysis..





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It was proposed that the cream could be administered in the rst instance to colonized individuals to clear staphylococci rapidly from the most anterior part of the nasal mucosa, where most bacteria are found A spray containing a mucoadhesive formulation of the enzyme, which is cheaper and easier to use, could be applied next to prevent recolonization Using a spray alone would likely be less effective because it is dif cult to deliver to the most anterior part of the nose Another important prophylactic application of anti-staphylococcal lytic enzymes might be the prophylaxis of catheter-related bloodstream infections, which are most often caused by coagulase-negative staphylococci and S aureus The ef cacy of lysostaphin in this regard was shown in an interesting study, which revealed that enzyme molecules can be readily adsorbed onto the catheter surface without losing their antibacterial activity (Shah et al 2004).

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that used laboratory stressors, NKCC was decreased, and students who reported the highest levels of loneliness had the lowest NKCC (Kiecolt-Glaser et al, 1984) Compared to the less stressful baseline period, examination stress also impaired blastogenic responses to the mitogens PHA and concanavalin A (Con A; Glaser, Kiecolt-Glaser, Stout, et al, 1985) An inhibition of the memory immune (blastogenic) response to Epstein-Barr Virus (EBV) polypeptides was also observed (Glaser et al, 1993) Production of interferon-gamma (IFN), an important antitumor and antiviral cytokine (Bloom, 1980), was decreased in leukocytes obtained at the time of exams (Glaser, Rice, Speicher, Stout, & Kiecolt-Glaser, 1986) Additional studies con rmed examination stressinduced changes in leukocyte numbers (Maes et al, 1999), serum immunoglobulin levels (Maes et al, 1997), and cytokine production (Maes et al, 1998).

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Lysostaphin adsorbed on the catheter surface could not only prevent S aureus surface colonization but also kill bacteria in solution within the catheter lumen While increasing the coating time resulted in a more potent antibacterial.

Comparison of the delayed type hypersensitivity (DTH) response to acute stress in animals and humans adds complexity to the domain of acute stress For example, stress associated with an academic examination suppressed DTH responses in subjects who reported higher levels of stress (Vedhara & Nott, 1996), while acute restraint stress in rodents during the sensitization or challenge phase enhanced DTH responses (Dhabhar & McEwen, 1997; Dhabhar, Satoskar, Bluethmann, David, & McEwen, 2000) In another study, socially inhibited individuals showed heightened DTH responses compared to controls following ve weekly sessions of high-intensity social engagement (Cole, Kemeny, Weitzman, Schoen, & Anton, 1999) Further research will be required to understand these complex interactions The clinical importance of the immunological changes associated with examination stress is underscored by several ndings.

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