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Although telepsychiatry is not new, the COVID-19 pandemic has dramatically boosted and legitimized it, especially in the field of group therapy. Group therapists have been forced to move online without enough training in leading online groups. Online groups are not the same as meeting in person and present specific obstacles and challenges that should either be compensated for or acknowledged as losses. In this article, the author summarizes these obstacles, identifying factors in group therapy, such as body-to-body interaction, that are absent online and suggesting ways to compensate for other differences, such as the therapist's reduced control over the setting. Surprisingly, some group members may benefit from online groups more than from in-person ones, but the online format is not for everyone. Research on online therapy has already shown this format's effectiveness, and the therapeutic alliance that is positively correlated with outcome seems to be achievable online as well. However, more research is needed, especially on cohesion in online groups, which seems to develop slower online.

Ravit Raufman’s paper contributes to the bridging gap between relational approaches and group therapy. It is also important in its recognizing the (group) therapist’s aggression and suggesting how to use it in the service of the group development. In this review I focus on the dynamics of a group of women led by a woman to explain some of the phenomena that Raufman describes in her article, and I add some social unconscious ideas to enrich our understanding of that group.

Background: Online group therapy is a relatively new modality for leading groups There is not enough research yet to evaluate its effectiveness and no clear guidelines about how to do it well With the outbreak of the COVID-19 pandemic it became even more crucial to provide clinicians with appropriate research review and practical guidelines The purpose of this article was to provide practice recommendations based on or despite the limited research Method: The article reviewed research on online therapy in general, including any on groups, followed by a summary of the obstacles in leading groups online and recommendations for creative solutions Findings: Research on online groups is still scarce, and its quality still has many limitations Discussion: More research is needed, especially on specific elements in online group therapy, such as the establishing of cohesion and therapeutic presence online, as well as how different the working alliance and cohesion are created online when compared to face-to-face groups Despite limited research, the author recommends being more active and increasing self-disclosure in online groups to compensate for the challenge of being present and the lack of body-to-body interaction Training for online group therapy is necessary (PsycInfo Database Record (c) 2020 APA, all rights reserved) Impact Statement Highlights and Implications-*Two of the ingredients of the therapeutic alliance, agreeing on the goals and tasks, can easily be achieved in online groups The third one, the quality of relationship, is still questionable *The absence of body-to-body interaction in online groups may be considered the main obstacle in shifting from the circle to the screen The absence of eye contact is especially relevant for group therapists *Presence is difficult to achieve through screen relations There are too many distractions Increasing the group therapist's self-disclosure and encouraging group members to use their imagination may be of help *Moving from in-person to online group therapy requires knowledge and training, just as when moving from individual therapy to group therapy (PsycInfo Database Record (c) 2020 APA, all rights reserved)

All group therapy textbooks emphasize the importance of the setting for a successful outcome of the group. This setting includes clear boundaries of time and space, stable participation, and good leadership. All are seen as requirements to create a safe enough environment for participants to work on deep issues. In addition, for its normal development and progress, the group is expected to go through a stormy stage with disagreements and conflicts. My article will highlight groups that do not follow such ‘rules’. Surprisingly, the members are still able to work at deep levels, create intimate relationships, and benefit from the group. How is this possible? Should we change our theories? I link the success of these groups to the secure presence (Neeman-kantor, 2013, researching outdoor groups of wives of Israeli soldiers who suffer from war PTSD) of the leader and the imagined internalized group that the members create. Applying field theory explains how a multi-unconscious-fantasy makes these impossible groups possible.

ABTRACTThis article deals with different modes of skin-related experiences in the social unconscious as expressed in two social products: fairy tales and group therapy processes. The phenomenon of the realization of a skin-related idiomatic expression that appears in fairy tales will be analyzed in order to touch upon the relations between concrete and symbolic modes of expressions in the social unconscious. This is based on previous works, showing that fairy tales reside along the seam line between thinking in words and thinking in images. A vignette from a therapy group shows its relevance to group psychotherapy.

The article discusses aspects of blindness in the social unconscious as reflected in two literary products: fairy tale and short story. The discussion includes analysing the texts themselves and the analysis of a group’s reaction to such text. This examination helps in learning about both the somatic and metaphoric level of the social unconscious. Focusing on a group of Israeli participants, this article presents the functions of blindness in dealing with the aftermath of collective trauma and guilt in the Israeli social unconscious.

(2014). Commentary on “Social Positions, Scripts, and Functioning Dynamics: Phenomenology of the Egyptian Social Unconscious”. International Journal of Group Psychotherapy: Vol. 64, No. 3, pp. 345-350.

Summary Israelis have a reputation for being quite individualistic, but no one can compete with their social and group spirit. This quality is prominent especially in times of personal and national distress. The public' quest for mutual help and affiliation needs are especially apparent during these stressful periods. When an Israeli is in distress, friends, neighbors, and good people will surround him to offer material or spiritual assistance. When the nation experiences difficulties, such as periods of war or waves of terror attacks, there are many spontaneous expressions of mutual help, cohesion, and getting together. There is an interesting phenomenon in Israel; group therapy blossoms after each war. People become interested in group work and more therapeutic groups become available.

Many authors describe a stage of maturity in the development of groups, but each highlights a different dimension. This article describes the characteristics of the advanced stage and the main axes along which it develops (internalization and containment, symbolization, self and self-other development, differentiation and individuation). It also offers a conceptual explanation for these developments and attempts to identify the conditions necessary for the emergence of this stage of maturity. An understanding of this stage and the conditions required for its development can be used by the group leader as a compass to help him or her navigate the group toward this objective.

The distribution of extracellular matrix vesicles on the third day of bone healing was studied by morphometric analysis of transmission electron micrographs. Detection and grouping of the vesicles was performed according to type, diameter, and distance from the calcified front. The different types were selected as follows: vesicles with electron-lucent contents (“empty”), vesicles with amorphous electron-opaque contents (“amorphic”), vesicles containing crystalline depositions (“crystal”), and vesicles containing crystalline structures with ruptured membranes (“rupture”). The majority of vesicles were between 0.07 µm and 0.12 μm in diameter and were located at less than 3 μm from the calcified front. The distribution of the “empty”, “amorphic”, “crystal”, and “rupture” vesicles was 23.2%, 74%, 2.5%, and 0.3% respectively. Their sequence of arrangement according to diameter was as follows: “empty”, “amorphic”, “crystal”, and “rupture”, the empty vesicles constituting the smallest and the “rupture” the largest type. Distances from the calcified front were similar for the “empty”, “amorphic”, and “crystal” vesicles, while the “rupture” type was located nearest to the front. The present observations support the widely acknowledged hypothesis on the role of extracellular matrix vesicles in mineralization. It is thought that the secretion of “empty” vesicles from the cell is followed by intravscular accumulation of amorphous Ca and Pi to form a hydroxyapatite crystal that, in turn, ruptures the vesicle's membrane. The maturation process is accompanied by an increase of the vesicular diameter and its approximation to the calcifying front.

In rabbits, an experimental model of fat embolism was produced that simulates the course of events in the clinical situation. Small doses of fat-cell suspension (0.075 ml/kg of body weight), prepared by collagenase treatment of homologous adipose tissue, were injected intravenously. Concomitantly, hypovolemia was produced in two animal groups by either withdrawing 20 percent of the estimated Mood volume or by application of a hind-limb ischemic tourniquet for 90 minutes. The presence of pathoanatomic characteristics typical of fat embolism was evaluated by recording lung/body weights, macroscopic appearance, and semiquantitative microscopic estimation in the lungs of edema, hemorrhage, atelectasis, intravascular coagulation, and leukocytic thrombi. Mean indices of lung/body weight were higher in all animals receiving injections of fat-cell suspension, as compared to controls. The score for microscopic generalized pulmonary damage was significantly higher in rabbits exposed to both fat-cell injections and hypovolemia than in controls or after fat-cell injections alone. It is concluded that hypovolemia enhances the development of fat embolism in rabbits subjected to small doses of fat-cell suspension.

A study of the distribution of extracellular matrix vesicles on the 6th day of bone healing was performed by methods of transmission electron microscopy combined with computerized morphometry. The vesicles were detected on the electron micrographs and grouped according to their diameters, distance from the calcified front and type. The different types were selected as follows: (a) vesicles with electron-lucent contents, i.e. ‘empty’; (b) vesicles with amorphous electron-opaque contents, i.e., ‘amorphous’; (c) vesicles containing crystalline depositions, i.e., ‘crystal’, and (d) vesicles containing crystalline structures with ruptured membranes, i.e. ‘rupture’. Most of the vesicles were concentrated between diameters of 0.02 and 0.22 µm. Most of the vesicles were found within a distance of less than 3 µm from the calcified front. The vesicles were distributed according to their types: ‘empty’, ‘amorphous’, ‘crystal’ and ‘rupture’ in 14, 39, 34 and 13%, respectively. The diameters of the ‘crystal’ and ‘rupture’ vesicles were significantly larger than those of the ‘empty’ and ‘amorphous’ types. The sequence of distances from the calcified front was recorded as follows: ‘rupture’, ‘crystal’, ‘amorphous’ and ‘empty’, the ‘rupture’ type being the closest to the front. The results of the present study confirm the accepted hypothesis on calcification via extracellular matrix vesicles. It is thought that the cell secretes ‘empty’ vesicles that accumulate amorphous Ca and P to form a hydroxyl-apatite crystal. This is followed by rupture of the vesicular membrane. The propagation of the process is accompanied by increase in the vesicular diameter and its approximation to the calcifying front.

A new method is presented for arthrodesis of small joints in the hand. In this method Kirschner wires are inserted dorsoventrally through the phalanges on either side of the joint, and the external ends bent into hooks. Longitudinal compression is achieved by connecting these hooks with rubber bands. This technique gives a solid and painless immobilization in a proper position, and the latter can be corrected easily when necessary. We arthrodesed 46 joints in 39 patients by this method in 1975 and 1976. The fusion time was 4 to 6 weeks, and the method produced a good bony arthrodesis in 42 of the 46 fingers.

A study of the distribution of extracellular matrix vesicles during the first 3 weeks of healing of adult rat tibial bone was performed by transmission electron microscopy in combination with computerized morphometry. Bone injury comprised removal of the marrow followed by regeneration of the tissue via a phase of primary mineralization. A total number of 39,498 vesicles were traced on electron micrographs and sorted according to their diameters, distance from the calcified front and types. The different vesicular types were defined as follows: (a) vesicles with electron lucent contents, i.e. “empty”, (b) vesicles with amorphous electron opaque contents, i.e. “amorphic”, (c) vesicles containinhg crystalline depositions, i.e. “crystal”, and (d) vesicles containing crystalline structures with ruptured membranes i.e. “rupture”. The vesicles were studied on the days 3, 6, 14 and 21 after bone injury. Most of the vesicles were concentrated between diameters of 0.07 and 0.17 μm. Most of the vesicles were found in a distance less than 3 μm from the calcified front. The sequence of changes of distances from the calcified front and of the vesicular diameters were recorded as follows: “rupture”, “crystal”, “amorphic” and “empty”, the “rupture” type being the closest to the front and of the largest diameter in each day. The results of the present study confirm the accepted hypothesis on calcification via extracellular matrix vesicles. It is thought that the cell secretes “empty” vesicles that accumulate Ca and Pi forming amorphous calcium phosphate that is then converted to hydroxyapatite. This is followed by rupture of the vesicular membrane. The maturation of the process herein on each day is accompanied by increase in the vesicular diameter and its approximation to the calcified front. With the propagation of healing the vesicles of all types decreased in diameter and distance from the calcified front. This process is accompanied by increase in the number of the mature vesicles and decrease in the number of the young vesicles.

We have related the radiographic width of the psoas muscle to age, degree of osteoporosis, height, and weight, and to constitution in 234 subjects. The psoas width correlated well with age. When the subjects were grouped according to age, an association was observed between narrowing psoas width and increasing osteoporosis. Narrowing of the psoas was evident some years prior to radiographic evidence of osteoporosis.

We describe a new technique to treat the mallet finger deformity. The method is both simple and efficient, and it does not require follow-up for splint or dressing adjustment. All of our 15 cases regained function without complications.

1 . Sloughing of homogenous skin grafts and clouding of corneal transplants have been shown to be due to antigen-antibody reaction; antigens A and B have been demonstrated in human epidermis and corneal tissue; and anti-red-cell agglutination has been observed in dogs after homogenous bone transplantation. Human bone was therefore examined in thirty-three experiments to determine the presence or absence of A and B antigens. 2. The bone was separated into hard cortical bone, hard washed cancellous bone and soft-tissue washings of bone. 3. Adsorption experiments showed that A and B antigens are absent from cortical bone. A and B antigens are present in cancellous bone.

The relationship between extracellular matrix vesicles and the calcifying fronts was examined by studying vesicular diameters and types. Transmission electron microscopy combined with computerized morphometry three weeks after injury to the tibial bone in rats was used. The different vesicle types were defined as: (1) vesicles with electron lucent contents referred to as empty; (2) vesicles with amorphous electron opaque contents, called amorphic; (3) vesicles containing crystalline depositions, called crystalline; and (4) vesicles containing crystalline structures with ruptured membranes, referred to as ruptured. The diameters of most vesicles ranged between 0.07 and 0.17 micron. More than 95% of the vesicles were located less than 2 micron from the calcified front. The vesicles were distributed among the categories as follows: empty, 9.6%; amorphic, 19.3%; crystal, 39.2%; and ruptured, 31.9%, respectively. The diameters of the crystalline and ruptured vesicles were significantly larger than those of the empty and amorphic types. The ruptured type had the largest diameters. The sequence of distances from the calcified front was recorded as follows: ruptured, crystalline, amorphic, and empty, with the ruptured and crystalline types being the closest to the front. This study supports the accepted theory on matrix vesicle mineralization. The cell is responsible for secretion of empty vesicles that accumulate amorphous Ca and Pi to form a hydroxyapatite crystal. This is followed by rupture of the vesicular membrane. The propagation of the process is accompanied by an increase in the vesicular diameter and its approximation to the calcifying front.

The degree of regeneration in surgically repaired sciatic nerves in rats was measured using a simple new electrophysiologic method: comparison of the size of nerve responses evoked by stimulation distal and proximal to the anastomosis. Five different repair procedures were evaluated. After simple end-to-end suture anastomosis, about 40% of the severed parent fibers regenerated past the suture line. The result was substantially improved when the anastomosis was covered with a newly designed thin-wall silicone sheath which incorporated a narrow longitudinal slit. The presence of suture material at the point of anastomosis had no effect. Finally, regeneration across a 5-mm gap ensheathed in silicone (67%) was better than regeneration through a 5-mm autograft (45%).

In spite of the existence of a powerful armamentarium of antibiotics, acute osteomyelitis continues to present a challenge as regards both health and life. Since the initial claims of the modern antibiotic era, it is now generally agreed that acute osteomyelitis is principally a surgical problem. Basic principles of early diagnosis, early antibiotic therapy, and, when necessary, early surgical intervention, continue to be fundamental. These, if correctly applied, may help to avert the occasional death. The following is a case in which these principles were not adhered to, a case which ultimately proved fatal owing to septicemic sequelae. Report of Case The patient was a girl aged 10 who had been epileptic since infancy. After one of these epileptic attacks, she began to complain of pain in the left leg just below the knee. The pain soon disappeared, but three days later she again had an attack of severe pain

Costovertebral arthritis was found to be a frequent condition in a study of 346 skeletons and 100 roentgenograms. It followed a definite pattern of distribution, which seems to be related to the anatomical characteristics of the joints and the ribs involved at the different thoracic levels. No differences were found between the races and sexes. In a few patients in which the diagnosis of costovertebral arthritis was established, local treatment was tried with good results.

Mycobacterium fortuitum was isolated from the synovial tissues of the dorsum of the hand after a dog bite. Caseating granulomas with Langhans' type giant cells were demonstrated microscopically. Healing followed prolonged treatment with antituberculosis drugs. It is suggested that the organism was forced into the patient's tissues by the dog's bite.