bluuebunny/crossref_metadata_2025 huggingface dataset:
A network of nuclear envelope proteins and cytoskeletal force generators mediates movements of and within nuclei throughoutCaenorhabditis elegansdevelopment
Authors: Starr Daniel A
Published: September 2019

Nuclear migration and anchorage, together referred to as nuclear positioning, are central to many cellular and developmental events. Nuclear positioning is mediated by a conserved network of nuclear envelope proteins that interacts with force generators in the cytoskeleton. At the heart of this network are linker of nucleoskeleton and cytoskeleton (LINC) complexes made of Sad1 and UNC-84 (SUN) proteins at the inner nuclear membrane and Klarsicht, ANC-1, and Syne homology (KASH) proteins in the outer nuclear membrane. LINC complexes span the nuclear envelope, maintain nuclear envelope architecture, designate the surface of nuclei distinctly from the contiguous endoplasmic reticulum, and were instrumental in the early evolution of eukaryotes. LINC complexes interact with lamins in the nucleus and with various cytoplasmic KASH effectors from the surface of nuclei. These effectors regulate the cytoskeleton, leading to a variety of cellular outputs including pronuclear migration, nuclear migration through constricted spaces, nuclear anchorage, centrosome attachment to nuclei, meiotic chromosome movements, and DNA damage repair. How LINC complexes are regulated and how they function are reviewed here. The focus is on recent studies elucidating the best-understood network of LINC complexes, those used throughout Caenorhabditis elegans development.

Impact statement

Defects in nuclear positioning disrupt development in many mammalian tissues. In human development, LINC complexes play important cellular functions including nuclear positioning, homolog pairing in meiosis, DNA damage repair, wound healing, and gonadogenesis. The topics reviewed here are relevant to public health because defects in nuclear positioning and mutations in LINC components are associated with a wide variety of human diseases including muscular dystrophies, neurological disorders, progeria, aneurysms, hearing loss, blindness, sterility, and multiple cancers. Although this review focuses on findings in the model nematode Caenorhabditis elegans, the studies are relevant because almost all the findings originally made in C. elegans are conserved to humans. Furthermore, C. elegans remains the best described network for how LINC complexes are regulated and function.
Using projective exercises to identify patient perspectives of living with comorbid type 2 diabetes and asthma
Authors: Litchman Michelle L , Allen Nancy A , McAdam-Marx Carrie , Feehan Michael
Published: September 2019

Objective

Patient self-management of a single chronic condition can be challenging, but few studies have examined the emotional impact of living with comorbid conditions and how that differs from a single chronic condition. This study examined patient perspectives of the emotional impact of living with asthma or asthma with comorbid type 2 diabetes (asthma+diabetes).

Methods

Data were collected from 41 adults (asthma only n = 22, asthma+diabetes n = 19) using semi-structured interviews on two separate online bulletin boards. Respondents engaged in discussions that leveraged two projective exercises: describing their health condition(s) as an animal, and selecting one of eight images that best illustrated how they were living with and managing their health condition(s).

Results

Respondents described physical and emotional challenges related to managing asthma or asthma+diabetes. Animal- and image- projective exercises were categorized by response and health condition. Thematic analysis across both projective exercises identified four themes: (1) frustrations with dual diagnosis, (2) juggling the dual diagnosis, (3) anticipating the future, and (4) unpredictability.

Discussion

Projective exercises are one way to elicit feelings about living with chronic conditions. Healthcare providers can improve support for patients with more than one health condition by providing education on how to manage comorbid conditions.
Learning from the experience of peer support facilitators and study nurses in diabetes peer support: A qualitative study
Authors: Holman Daniel , Simmons David , Ockenden Nick , Graffy Jonathan Peter
Published: September 2019

Objectives

We report on the experiences of peer support facilitators and study nurses who participated in a large trial of peer support for type 2 diabetes. The support was led by volunteer peer support facilitators, who were trained in overcoming barriers to diabetes care, motivational interviewing, listening skills and setting up and running group support sessions. There is currently a distinct lack of qualitative evidence on what works in peer support.

Methods

The peer support facilitators and study nurses completed open-answer questionnaire items on what worked well and less well, problems encountered and how they were resolved, group dynamics and suggestions for improvement. We also collected data from end-of-study meetings. Inductive thematic analysis was used to allow the emergent themes to be strongly based in the data. Findings: We find that process factors, peer support facilitator and peer characteristics, their relationships with each other and group dynamics are all fundamental for effective peer support. Sustaining and ending support also emerged as a key theme.

Discussion

Given the increasing interest in peer support, these findings will be useful to those interested in running groups in the future. Training programmes should help peer support facilitators develop confidence whilst emphasising that peer support ideally entails an equal, democratic dynamic. More attention is needed on to how to end groups appropriately.
Launching ‘Namaste Care’ in Canada: findings from training sessions and initial perceptions of an end-of-life programme for people with advanced dementia
Authors: Kaasalainen Sharon , Hunter Paulette V , Hill Courtney , Moss Rachel , Kim Joy , van der Steen Jenny T , Dal-Bello Haas Vanina , Hadjistavropoulos Thomas
Published: September 2019

Background

Multisensory approaches and programmes have been developed to improve the quality of both life and dying for people with advanced dementia. However, little is known about the experiences of staff, family and others involved in the use of these programmes, and in the relevant education provided to improve the quality of life of residents living with advanced dementia in long-term care homes.

Aim

The aim of this study was to explore early experiences associated with the implementation of a new programme called ‘Namaste Care’ in two Canadian long-term care homes.

Methods

A multiple methods design was used. This included a survey to evaluate a 2-day education programme and qualitative description of interview data that explored experiences during the first 3 months of implementation.

Results

Survey respondents included 44 long-term care staff and 44 others (primarily family) who had attended a 2-day training session or public lecture. Interviews were undertaken with 18 staff, 5 family members and 2 volunteers to generate qualitative descriptions about the last 3 months of implementation of the 2-day education programme. The majority of those who attended training rated this as excellent and affirmed that they now understood the purpose of ‘Namaste Care’. Most endorsed that they had learned some essentials of ‘Namaste Care’ delivery. The majority of those who attended the public lecture were very satisfied with the education, and better understood how this novel programme could be implemented in long-term care. Qualitative description of interview data revealed that participants were positive about ‘Namaste Care’ in long-term care, and identified both barriers and facilitators to implementation as well as recommendations to help with future implementation.

Conclusions

These study findings support the use of a facility-wide educational programme to help launch a new innovation in long-term care.
Lessons learnt: examining the use of case study methodology for nursing research in the context of palliative care
Authors: Brogan Paula , Hasson Felicity , McIlfatrick Sonja
Published: September 2019

Background

An empirical social research approach, facilitating in-depth exploration of complex, contemporary contextualised phenomena, case study research has been used internationally in healthcare studies across clinical settings, to explore systems and processes of care delivery. In the United Kingdom, case study methods have been championed by nurse researchers, particularly in the context of community nursing and palliative care provision, where its applicability is well established. Yet, dogged by conceptual confusion, case study remains largely underutilised as a research approach.

Method

Drawing on examples from nursing and palliative care studies, this paper clarifies case study research, identifies key concepts and considers lessons learned about its potential for nursing research within the unique and complex palliative and end of life context.

Conclusion

A case study approach offers nurse researchers the opportunity for in-depth, contextualised understanding of the systems and processes which influence their role in palliative care delivery across settings. However, philosophical and conceptual understandings are needed and further training in case study methodology is required to enable researchers to articulate and conduct case study.
Constraint-induced or multi-modal personalized aphasia rehabilitation (COMPARE): A randomized controlled trial for stroke-related chronic aphasia
Authors: Rose Miranda L , Copland David , Nickels Lyndsey , Togher Leanne , Meinzer Marcus , Rai Tapan , Cadilhac Dominique A , Kim Joosup , Foster Abby , Carragher Marcella , Hurley Melanie , Godecke Erin
Published: September 2019

Rationale

The comparative efficacy and cost-effectiveness of constraint-induced and multi-modality aphasia therapy in chronic stroke are unknown.

Aims and hypotheses

In the COMPARE trial, we aim to determine whether Multi-Modal Aphasia Treatment (M-MAT) and Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) are superior to usual care (UC) for chronic post-stroke aphasia. Primary hypothesis: CIAT-Plus and M-MAT will reduce aphasia severity (Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ)) compared with UC: CIAT-Plus superior for moderate aphasia; M-MAT superior for mild and severe aphasia.

Sample size estimates

A total of 216 participants (72 per arm) will provide 90% power to detect a 5-point difference on the WAB-R-AQ between CIAT-Plus or M-MAT and UC at α = 0.05.

Methods and design

Prospective, randomized, parallel group, open-label, assessor blinded trial. Participants: Stroke >6 months; aphasia severity categorized using WAB-R-AQ. Computer-generated blocked and stratified randomization by aphasia severity (mild, moderate, and severe), to 3 arms: CIAT-Plus, M-MAT (both 30 h therapy over two weeks); UC (self-reported usual community care).

Study outcomes

WAB-R-AQ immediately post-intervention. Secondary outcomes: WAB-R-AQ at 12-week follow-up; naming scores, discourse measures, Communicative Effectiveness Index, Scenario Test, and Stroke and Aphasia Quality of Life Scale-39 g immediately and at 12 weeks post-intervention; incremental cost-effectiveness ratios compared with UC at 12 weeks.

Discussion

This trial will determine whether CIAT-Plus and M-MAT are superior and more cost-effective than UC in chronic aphasia. Participant subgroups with the greatest response to CIAT-Plus and M-MAT will be described.
The Mild and Rapidly Improving Stroke Study (MaRISS): Rationale and design
Authors: Romano Jose G , Gardener Hannah , Campo-Bustillo Iszet , Khan Yosef , Riley Nikesha , Tai Sofie , Sacco Ralph L , Khatri Pooja , Smith Eric E , Schwamm Lee H
Published: September 2019

Rationale

Although mild and rapidly improving stroke symptoms are the most common first stroke presentation, this group has been understudied in acute stroke trials. Observational and retrospective studies suggest residual disability in one third of patients.

Aims

To elucidate long-term outcomes of patients with mild and rapidly improving stroke, evaluate the predictors of outcome, and examine the association with alteplase treatment.

Sample size

The initial estimate of 2650 participants to detect a 9% difference in non-disabled 90-day outcomes between alteplase-treated and untreated participants was revised to 2000 after a pre-planned re-estimation based on actual treatment rates.

Methods and design

Prospective observational study of patients with mild ischemic stroke (NIHSS ≤ 5) or rapidly improving stroke symptoms evaluated within 4.5 h from onset.

Outcomes

The primary outcome is the proportion of patients with modified Rankin Scale (mRS) ≥ 2 at 90 days; the primary safety outcome is symptomatic hemorrhagic transformation within 36 h among those treated with alteplase. Secondary outcomes include the 90-day Barthel Index, Stroke Impact Scale 16, European Quality of Life scale, mRS at 30 days, and 30- and 90-day mortality.

Discussion

MaRISS will define outcomes and their predictors and clarify the effects of alteplase in patients with mild and rapidly improving stroke symptoms, providing clinicians with important information to manage this population.
Trapeziometacarpal total joint arthroplasty for osteoarthritis: 199 patients with a minimum of 10 years follow-up
Authors: Martin-Ferrero Miguel , Simón-Pérez Clarisa , Coco-Martín Maria B. , Vega-Castrillo Aureliio , Aguado-Hernández Héctor , Mayo-Iscar Agustín
Published: September 2019

We report outcomes of 228 consecutive patients with total joint arthroplasty using the Arpe® prosthesis, among which 216 trapeziometacarpal joints in 199 patients had a minimum of 10 years follow-up. The cumulative survival rate of the 216 implants at 10 years using the Kaplan–Meyer method was 93%. Two hundred joints were functional and painless. We found good integration and positioning of the components in 184 (93%) of the joints. Sixteen prostheses failed. We conclude that this implant has acceptable long-term survival rate and restores good hand function. We also report our methods to improve implant survival and to decrease the risk of component malpositioning, and failure rate.

Level of evidence: II
Propylene glycol alginate sodium sulphate attenuates LPS-induced acute lung injury in a mouse model
Authors: Zhao Peng , Liu Guoliang , Cui Yunfeng , Sun Xufang
Published: September 2019

Propylene glycol alginate sodium sulphate, a sulphated polysaccharide, has been used to treat hyperlipidaemia and ischaemia–reperfusion injury of liver. This study aimed to investigate the effect of propylene glycol alginate sodium sulphate on LPS-induced acute lung injury. Propylene glycol alginate sodium sulphate was injected intraperitoneally into male C57BL/6 mice with or without LPS administration. Survival rates were calculated. Serum, bronchoalveolar lavage fluid and lung tissues were collected to determine lung histology, wet/dry ratio, Evans blue albumin permeability, protein levels, the counts of immune cells and the levels of inflammatory cytokines and chemokines. Serum alanine aminotransferase, aspartate transaminase, creatinine and blood urea nitrogen levels were also measured. Additionally, NF-κB signalling was detected in the lung. Propylene glycol alginate sodium sulphate treatment significantly improved the survival of mice suffering from LPS. Lung histological injury, wet/dry ratio, Evans blue albumin permeability, neutrophils and the inflammatory cytokines and chemokines were significantly reduced by propylene glycol alginate sodium sulphate treatment. NF-κB signalling was significantly inhibited by propylene glycol alginate sodium sulphate in the lung of mice subjected to LPS. Furthermore, serum alanine aminotransferase, aspartate transaminase, creatinine and blood urea nitrogen levels were also significantly decreased after propylene glycol alginate sodium sulphate administration. This study suggests that NF-κB signalling and inhibition of pro-inflammatory cytokines, chemokines and neutrophil accumulation may be involved in the process of acute lung injury attenuation by propylene glycol alginate sodium sulphate.
The Pupillary Response to the Unknown: Novelty Versus Familiarity
Authors: Beukema Steve , Jennings Ben J. , Olson Jay A. , Kingdom Frederick A. A.
Published: September 2019

Object recognition is a type of perception that enables observers to recognize familiar shapes and categorize them into real-world identities. In this preregistered study, we aimed to determine whether pupil size changes occur during the perception and recognition of identifiable objects. We compared pupil size changes for familiar objects, nonobjects, and random noise. Nonobjects and noise produced greater pupil dilation than familiar objects. Contrary to previous evidence showing greater pupil dilation to stimuli with more perceptual and affective content, these results indicate a greater pupil dilation to stimuli that are unidentifiable. This is consistent with the relative salience of novelty compared to familiarity at the physiological level driving the pupil response.
CD38 expression on gluten‐specific T cells is a robust marker of gluten re‐exposure in coeliac disease
Authors: Zühlke Stephanie , Risnes Louise Fremgaard , Dahal-Koirala Shiva , Christophersen Asbjørn , Sollid Ludvig M , Lundin Knut EA
Published: September 2019

Background

Increasing efforts are being put into new treatment options for coeliac disease (CeD), a chronic disorder of the small intestine induced by gluten. Interleukin‐2 (IL‐2) and gluten‐specific CD4 + T cells increase in the blood after four hours and six days, respectively, following a gluten challenge in CeD patients. These responses are unique to CeD and are not seen in controls. We aimed to evaluate different markers reflecting a recall response to gluten exposure that may be used to monitor therapy.

Methods

CeD patients on a gluten‐free diet underwent a one‐ (n = 6) or three‐day (n = 7) oral gluten challenges. We collected blood samples at several time points between baseline and day 8, and monitored gluten‐specific CD4 + T cells for their frequency and CD38 expression using HLA‐DQ:gluten tetramers. We assessed the IL‐2 concentration in plasma four hours after the first gluten intake.

Results

The frequency of gut‐homing, tetramer‐binding, CD4 + effector memory T (tetramer + β7 + TEM) cells and the IL‐2 concentration measured shortly after the first dose of gluten increased significantly after the one‐ and three‐day gluten challenges, but large interindividual differences were exhibited. The frequency of tetramer + β7 + TEM plateaued between days 6 and 8 and was lower after the one‐day challenge. We observed a consistent increase in CD38 expression on tetramer + β7 + TEM cells and did not find a significant difference between the one‐ and three‐day challenges.

Conclusions

The optimal time points for monitoring therapy response in CeD after a three‐day oral gluten challenge is four hours for plasma IL‐2 or six to eight days for the frequency of tetramer + β7 + TEM cells, but both these parameters involved large interindividual differences. In contrast, CD38 expression on tetramer + β7 + TEM cells increased uniformly and irrespectively of the length of gluten challenge, suggesting that this parameter is more suited for monitoring drug efficacy in clinical trials for CeD.
An experimental study of the effect on activity intentions of postconcussion recovery advice
Authors: Sullivan Karen A , Billing Leanne
Published: September 2019

This study tested the effect of issuing return-to-activity advice on activity intentions at Day 2 and Day 10 days post simulated mild traumatic brain injury. One hundred and twenty-eight volunteers were randomly allocated to one of two groups who received ( n =  65) or did not receive standardized post-injury advice ( n =  63). To prime the simulation, the participants read a mild traumatic brain injury vignette about a person who is concussed while playing sport. Then the participants role-played the injured person and reported activity intentions for three activity types (cognitive, physical and restful) twice, once for each time frame (i.e. Day 2 and Day 10). The advice was to rest for the first 24–48 h and then gradually resume normal activities. There was no significant group by activity-type interaction ( p > .05) at Day 2. When both time frames were considered, there was no significant group × time frame interaction for any activity type or any item, except for an increase in non-manual (clerical) work and weight training at Day 10 compared to Day 2 in the group with the advice. In general, the intentions for all activity types were consistent with the recovery advice (i.e., rest then increasing activity), even when the advice was not given. However, at Day 10, cognitive and physical activity levels were still expected to be lower than usual (pre-injury), and many participants were uncertain about the concept of cognitive rest. These factors, along with individual patient circumstances, should be taken into account in rehabilitation planning.
Impact of an Electronic Medical Record Alert on Code Status Documentation for Hospitalized Patients With Advanced Cancer
Authors: Switzer Benjamin , Jazieh Khalid , Bernstein Eden , Harris David
Published: September 2019

PURPOSE:

Cardiopulmonary resuscitation in hospitalized patients with advanced cancer is associated with high rates of morbidity and mortality. Although advance care planning (ACP) in this population improves quality, patient satisfaction, hospice use, rates of harm, and health care costs, ACP documentation rates remain low. We observed changes in ACP documentation by internal medicine residents within a tertiary hospital’s inpatient oncology service after a mandatory training module and enterprise-wide modification in electronic health medical records (EHMR).

METHODS:

For patients admitted to the Cleveland Clinic oncology service, this 16-week retrospective review observed resident code status (CS) documentation through admission notes and direct EHMR orders before and after implementation of an ACP training module and CS best practice alert (BPA). In addition, residents were surveyed on perceived barriers to CS documentation.

RESULTS:

In 535 unique admissions (244 before BPA, 291 after BPA), residents exhibited a 14.4% increase (from 47.1% to 61.5%) in admission note CS documentation and an 18.2% increase (from 12.7% to 30.9%) in CS orders at time of discharge. The most common self-reported barrier to ACP documentation was forgetting to discuss, with first-, second-, and third-year residents admitting to feeling uncomfortable in orchestrating ACP conversations at rates of 58%, 6%, and 5%, respectively.

CONCLUSION:

Resident ACP documentation remains suboptimal in the high-risk cohort of hospitalized patients with advanced cancer. However, rates seem to be positively influenced by online modules and EHMR-based interventions. Additional efforts to improve the current practice and culture of ACP remain a crucial aspect in the quality and safety of our approach to patient care.
Integrating Family Caregiver Support Into a Gynecologic Oncology Practice: An ASCO Quality Training Program Project
Authors: Campbell Grace B. , Boisen Michelle M. , Hand Lauren C. , Lee Young Ji , Lersch Nora , Roberge Mary C. , Suchonic Barbara , Thomas Teresa H. , Donovan Heidi S.
Published: September 2019

PURPOSE:

A needs assessment of family caregivers (CGs) in our gynecologic oncology clinic found that 50% of CGs report nine or more distressing unmet needs, but only 19% of patients had a documented CG. We conducted an ASCO Quality Training Program project with the following aims: (1) to identify and document primary CGs for 85% of patients within two clinic visits of a gynecologic cancer diagnosis, and (2) assess the needs of and provide interventions to 75% of identified family CGs.

METHODS:

Plan-Do-Study-Act (PDSA) methodology and tools endorsed by the ASCO Quality Training Program were used. An interprofessional team reviewed baseline data (ie, any mention of a family CG in the electronic health record visit note; CG distress survey), defined the problem and project aims, created process maps, and identified root causes of poor CG identification and documentation. Eight successive PDSA cycles were implemented between October 2018 and March 2019 to address identified root causes.

RESULTS:

For aim 1, CG identification increased from 19% at baseline to 57% postimplementation, whereas for aim 2, assessment improved from 28% at baseline to 60% postimplementation. Results fell somewhat short of initial goals, but they represent an important initial improvement in care. The core team has begun additional PDSA cycles to improve CG identification rates and extend the momentum of the project.

CONCLUSION:

This project demonstrated that a CG assessment protocol can be implemented in a large, academic, gynecologic oncology clinic. Additional efforts to integrate CG identification, assessment, and intervention more fully within the clinic and electronic health record are under way.
Psychiatry and organicity interface: A case series
Authors: Nemlekar Saumitra , Fernandes Wenona , Pednekar Tanvi , Waikar Shilpa , Pereira Yvonne
Published: September 2019

An agitated or suicidal patient brought by family or authorities at the A & E can be called as a prototypical psychiatric emergency. These individuals present with myriad of psychiatric symptoms which may have underlying organic etiologies and co-morbidities; final diagnosis should always be made after exclusion of such causes. At presentation identifying underlying medical condition masquerading as a psychiatric disorder can be difficult and challenging in such scenarios. We hereby present three cases where patients were admitted to a tertiary care set up with probable primary psychiatric syndromes; upon investigations were found to have medical co-morbidities ; which had pivotal implication on their management.
Study of various factors affecting compliance in schizophrenia: A single center experience in India
Authors: Shah Charmi
Published: September 2019

Aim of the study

Schizophrenia is a major psychiatric disorder, imparting a major burden in health care sector. Many treatments are available now a days to treat schizophrenia, although, its burden is not decreasing. The main reason behind this is noncompliance to treatment.This study aims to find out the non compliance prevalence and to study influence of sociodemographic factors, treatment related variables, illness related variables and various subjective reasonings in patients with schizophrenia.

Subject or material and methods

Over the period of 1 year, 80 patients with schizophrenia who gave written informed consent were enrolled in the study and their sociodemographic, treatment related and illness related variables were noted. PANSS(positive and negative syndrome scale for Schizophrenia) was used to indicate the severity of illness. ROMI(Rating of Medication Influences Scale in Schizophrenia) was used to assess subjective reasons. Chi square test was used to find out statistical significance.

Results

37.5% patients were non compliant in our study. Education, the illness severity, the type of regimen and dosages of medication have a significant influence on treatment compliance. The subjective reason “no perceived benefit” is significantly associated with treatment noncompliance.

Discussion

A wide literature is available across the globe on compliance in schizophrenia. This study aids in the available resources and throws a light on the regional factor.

Conclusions

Schizophrenia, being a major disease imparting burden in psychiatry health care system, needs an attention in the area of compliance to treatment. This type of research should be done on regional basis to find out and address the factors that influence treatment compliance.
Effectiveness of play-based empathy training on social skills in students with Autistic Spectrum Disorders
Authors: kazemi fahimeh , abolghasemi abbas
Published: September 2019

Aim of the study

This study was performed to investigate the effectiveness of play-based empathy training on social skills improvement in autistic students.

Subject or material and methods

it was a preliminary study with a pretest-posttest design, and a control group. The statistical population consisted all students with autism spectrum disorders in Rasht city in academic year 2016-17. The sample included 8 students selected via convenience sampling method, put randomly into the experimental (N=4) and control group (N=4). After taking the pretest through Social Skills Assessment (stone et al, 2010), the experimental group participated in 18 sessions (45-minutes) of play-based empathy training, while the control group received no intervention. At the end, the posttest was performed on both groups.

Results

The results showed that play-based empathy training could improve social skills in autistic students.

Discussion

The results provide support for the role of play-based empathy training in improving social skills and psychological health in students with Autism Spectrum Disorders.

Conclusions

The results provide support for the role of play-based empathy training in improving social skills and psychological health in students with Autism Spectrum Disorders.
Family and peer resources in relation to psychological condition in patients with paranoid schizophrenia
Authors: Izydorczyk Bernadetta , Sitnik-Warchulska Katarzyna , Kühn-Dymecka Aleksandra , Lizińczyk Sebastian
Published: September 2019

Aim of the study

The main objective of this study was seeking for the predictive role of social resources in maintaining the psychological condition by adults suffering from paranoid schizophrenia.

Subject or material and methods

The study group comprised 201 individuals, 95 females and 106 males, aged between 18 and 54, diagnosed with paranoid schizophrenia and being treated in psychiatric rehabilitation wards. The following instruments were used: clinical interview, a survey created the study, to measure life experience and coping with adverse life situations and their subjective outcomes for the social functioning, The Family Strengths Scale, The Perceived Social Support Scale, The Berne Questionnaire of Subjective Well-Being, The Positive and Negative Syndrome Scale, The Mood Scale, and The General Health Questionnaire. The correlation analysis and the path analysis were used.

Results

The results confirmed that family resources significantly and directly influence a decline in perceiving the psychological condition of patients with schizophrenia. Life experience intensifies disease indicators adverse to healing. More significance was discovered in the case of support from father and comrades. The higher support from comrades was significantly related with lower self-assessed mental health.

Discussion

The present study suggested that indicators of family and social support also mediate the intensity of indicators of healing and attenuation of disease indicators, and the source of support is highly important for the course of the disease.

Conclusions

The educational and psychotherapeutic actions aimed at enhancing beliefs concerning the role of family and peer support in the healing process should be included in the long-term treatment of patients with paranoid schizophrenia and their families.
Sense of coherence and psychological well-being in cardiac patients: Is the association mediated by self-efficacy?
Authors: Krok Dariusz , Kleszczewska-Albińska Angelika
Published: September 2019

Aim of the study

A large deal of research on cardiac patients concentrates on analyses of mutual relationships between sense of coherence and psychological well-being, sense of coherence and self-efficacy, or psychological well-being and self-efficacy. It has been proven that self-efficacy plays a crucial role as a mediator of the relationships between various psychological constructs.

Subject or material and methods

A total number of 176 patients (82 women and 94 men), age 45-82 years (M = 58.56, SD = 8.25) participated in the study. All participants were patients admitted to the cardiology department with coronary heart disease and undergoing medical interventions. All participants were asked to fill in the Polish adaptations of Sense of Coherence Scale (SOC-29), General Self-Efficacy (GSE) scale, and The Psychological Well-Being Scale (PWB).

Results

Positive correlations were found between sense of coherence (SOC), self-efficacy (SE), and psychological well-being (PWB), as well as between subscales of SOC and PWB. Positive correlations were revealed between SE and subscales of PWB as well. SE was proved as a mediator between SOC and PWB.

Discussion

Results obtained in the presented study provide an empirical proof of complexity of the relationship among sense of coherence, psychological well-being, and self-efficacy. The mediation of SE between SOC and PWB appears to be partial which indicates indirect effects among the variables.

Conclusions

The main finding was to demonstrate the mediating role of self-efficacy between sense of coherence and psychological well-being. Some additional personality variables need to be considered in further research.
Evolutionary psychiatry: enhancing our current knowledge of psychopathologies
Authors: Saniotis Arthur
Published: September 2019

Evolutionary psychiatry is a small discipline which has yet to have an established integrative framework. Current global prevalance of various psychopathologies demands new ways for thinking them in terms of both proximate and ultimate causal levels.

The author argues that evolutionary psychiatry can lead to developing a more integrative and comprehensive approach towards understanding the complex relationship between neuro-hormonal-endocrine regulation and human affectivity. This is certainly needed due to current mismatch in which human traits which had evolved during the Paleolithic period are increasingly maladaptive in novel and complex environments.
Acknowledging that the human brain is an on-going product shaped by evolutionary processes provides a way to interrogate global mental health problems.
The perception of aggression towards the medical personnel of psychiatric wards in Poland and in Norway – a comparative analysis
Authors: Lickiewicz Jakub , Nag Thomas , Ravnanger Conrad , Makara- Studzińska Marta , Jagielski Paweł
Published: September 2019

Aim of the study

The objective of the study was to find out whether there are differences in the attitudes and perception of patients’ aggression prevalent amongst groups of personnel from Poland and Norway. This issue has yet to be discussed in the subject literature; however, it should be assumed that such differences exist.

Subject or material and methods

Two tools were used to identify the attitudes of the medical personnel towards aggression: POAS (Perception of Aggression Scale) and ATAS (Attitudes Towards Aggression Scale). The research comprised 280 people – the personnel of psychiatric wards from the psychiatric hospital in Bergen, Norway (n= 140) and from the psychiatric hospitals in Żurawica and Jarosław in Poland (n= 140).

Results

Statistically significant differences were demonstrated between the attitudes and perception of aggression by the medical personnel in Poland and in Norway (p <0.001). The Norwegian personnel more frequently perceive aggression as positive behaviour, associated with the protection of one’s own territory. On the other hand, the Polish staff more often regard aggression as negative, offensive and intrusive behaviour.

Discussion

There are differences between the education and health care system in both countries. Education in Norway is strongly focused on communication with patients and their families. Another aspect is the problem of working conditions and the level of economic development. Furthermore, the character of the personnel’s work is also important.

Conclusions

The perception of aggression towards the medical staff of psychiatric wards in Poland and Norway differ. The manner of education, working conditions and ward culture might influence the attitudes and perception of aggression.
ICD-11 Mental, behavioural or neurodevelopmental disorders: innovations and managing implementation
Authors: Gaebel Wolfgang , Kerst Ariane , Cyranka Katarzyna
Published: September 2019

The International Classification of Diseases (ICD) by the World Health Organization (WHO) is the leading classification system for mental, behavioural or neurodevelopmental disorders (MBND) and somatic disorders worldwide (Gaebel et al., 2018). The eleventh revision of ICD - ICD-11 - was released by WHO in June 2018 and approved by the World Health Assembly (WHA) in May 2019.
The ICD-11 is an open source for the global community of clinicians in various settings, researchers, consumers, administrators, policy makers and governments. The ICD serves as a tool for clinical documentation and population statistics (Gaebel et al., 2017). To meet the needs of various users, different versions for different purpose will be available:
From Editors
Authors: Cyranka Katarzyna
Published: September 2019

This summer volume of APP we would like to start with one of the European Psychiatry leader’s, Prof. Wolfgang Gebel’s editorial on the latest revision of the International Classification of Diseases ICD11. Following approval of the ICD-11 by the World Health Assembly in May 2019, World Health Organization (WHO) member states will transition from the ICD-10 to the ICD-11, with reporting of health statistics based on the new system to begin on January 1, 2022. It will illustrate a set of new categories that have been added to the ICD-11 and present the rationale for their inclusion. This information is intended to be useful for both clinicians and researchers in orienting themselves to the ICD-11 and preparing for implementation in their own professional contexts.
Getting the best out of staff in a district nursing team: nurturing resilience
Authors: Duncan Monica
Published: September 2019

District nursing (DN) teams deliver high-quality, complex care under extremely difficult circumstances. DN team resilience depends on the balance between capacity (funding and staff availability) and demand (workload and both clinical and quality standards). The caseload is where capacity and demand meet. Resilience in teams is stretched to the limits and often breached, despite which district nurses remain positive about their role. The overwhelming issue appears to be high workload exacerbated by staff shortages and increasing referrals to DN services. The time is rapidly approaching when district nurses may not be able to keep their caseloads open. If demand and capacity are to be better aligned, the demand should be better predicted, so that lead times are considered and resources are available.
Potential of emotional freedom techniques to improve mood and quality of life in older adults
Authors: Harbottle Lynn
Published: September 2019

Emotional freedom techniques (EFTs) are an innovative combined somatic and cognitive therapy. Derived from key principles within traditional Chinese medicine, they incorporate elements of exposure, cognitive and other conventional psychotherapies. Increasing evidence suggests that EFTs are effective in treating various physical and psychological conditions and across several population groups. Studies indicate that the somatic component is essential to its ease of use, rapid effect and durability of results. EFTs can be used as self-help tools or applied therapeutically in groups or individually. There is a lack of research specifically examining its applicability to older adults, but a ground-breaking project with nurses in France suggests that EFTs may offer significant potential to moderate pain and stress levels and to improve mood, interaction and quality of life among this group, including those with multiple and complex comorbidities.
Pituitary conditions: importance of geography and the Pituitary Foundation in patient support
Authors: Underwood Anneliese , Norman Alyson , Jackson Sue
Published: September 2019

Quality of life is significantly impacted for those with pituitary conditions, and patients need support to meet ongoing physical and psychological needs. This study aimed to explore the support needs and experiences of patients with pituitary conditions in the community. Ten self-selected members of the Pituitary Foundation were interviewed about their conditions, needs and experiences. Data were analysed using thematic analysis. Secondary thematic analysis was conducted on data from a sample of 748 members of the Pituitary Foundation. Four themes were revealed, under one over-arching theme of geography: (1) life-changing diagnosis, (2) the Foundation as a source of support, (3) access to the Foundation and (4) attendance at support groups. On the basis of the findings of this study, the authors concluded that better training is required for health professionals about pituitary conditions, their long-term consequences and the need to signpost patients to wider services offering essential support.
Cryptococcosis with central nervous system involvement in a dog in the UK: a case report and review of the condition
Authors: Longo Sara , Esmieu Shanti , Pastorello Alice , Waine Katie , Baiker Kerstin , Cherubini Giunio Bruto
Published: September 2019

This case report describes the clinical presentation, diagnostic findings, treatment and outcome in a dog diagnosed with diffuse cryptococcosis with involvement of the central nervous system (CNS). This represents the fourth case of cryptococcosis with CNS involvement in dogs described in the UK. The dog presented with signs of multifocal brain disorder; investigations, including magnetic resonance imaging, cerebrospinal fluid analysis and serology, revealed cryptococcosis. As previously reported, despite treatment, in our case the outcome was extremely poor. Cryptococcosis is an opportunistic fungal disease distributed worldwide, which in dogs often causes disseminated disease with multi-organ involvement. Despite being rare in the UK, CNS cryptococcosis should be included as a possible differential diagnosis in healthy young to middle-aged dogs presenting with signs of diffuse, progressive central nervous system disease.
Apomorphine hydrochloride: a clinical review with retrospective analysis of use in 1126 dogs treated in emergency practice
Authors: Walmsley Darby W , Bray Jonathan P , Thomas Philip
Published: September 2019

Apomorphine is a non-selective dopamine agonist commonly used in veterinary medicine for the emergency management of toxicoses in dogs, through the induction of emesis. This review evaluates the currently reported effectiveness, adverse effects and recommendations of apomorphine as an emetic and considers alternatives. This is complemented by a retrospective study of 1126 dogs treated with apomorphine in emergency practice, to determine the efficacy of apomorphine in a clinical setting, and to provide identification of population characteristics, indications and outcomes of treated patients. The literature recognises apomorphine as a successful and consistent emetic for the retrieval of ingested harmful substances, with generally mild and self-limiting adverse effects. The retrospective study found that the most common reasons for presentation of the treated population were chocolate (26.8%), rodenticide (26.5%), foreign material (20.7%), and medication ingestion (11.6%). In this study, the two most influential factors on emetic and clinical outcome were the type of intoxicant and length of ingestion-to-presentation time. Breed size was an important determinant for the type of substance ingested, with variations noted between small, medium and large breed dogs. The most commonly estimated time from ingestion to presentation was 1–2 hours, with the substance, or parts thereof, successfully identified in the vomitus of 68.9% of cases. Apomorphine remains a valuable veterinary therapeutic for use in small animal emergency and critical care, providing a high rate of successful induction of emesis.
Supplementary therapy in canine atopic dermatitis
Authors: Paterson Sue
Published: September 2019

Therapy for canine atopic dermatitis can be described as foundation or supplementary. Foundation therapy, which refers to allergen-specific immunotherapy, ciclosporin, glucocorticoids, lokivetmab and oclacitinib, is needed in all but the mildest of cases of canine atopic dermatitis. Supplementary therapies include drugs such as antihistamines, essential fatty acids, topical therapy and other systemic anti-inflammatory drugs. While it is uncommon for any of these supplementary drugs to provide adequate control of many cases of canine atopic dermatitis, they can reduce the frequency of relapse and reduce the amount of foundation therapy that is required when used in combination with them.
Veterinary professionals ‘giving something back’
Authors: Forbes Neil A , Homer-Forbes Karen
Published: September 2019

Vultures in Africa as well as Asia have been and continue to be severely impacted by human activities. Veterinary professionals have the chance to help vulture (and other) conservation programmes, ‘give something back’ by training local professionals in relevant practical skills.
Post-travel pet clinics
Authors: Wright Ian
Published: September 2019

The number of pets travelling under the Pet Travel Scheme has increased year on year since its inception, with the number almost doubling between 2015 and 2017. In addition to this, climate change and human movement is affecting parasite distributions worldwide. The UK is at high risk of many exotic parasites becoming endemic if they are allowed to enter and a consistent strategy is key in preventing this from happening. Pets receiving preventative treatments and tick checks post travel are an essential part of this strategy and post-travel clinics provide an opportunity for advice and treatments to be given and health checks to be carried out. There is also an opportunity for client bonding with the veterinary practice, as a comprehensive pet travel service is then given both before and after the journey has been completed. This article considers post-travel clinics and the requirements of the pet returning to the UK.
Recognition and assessment of dementia in primary care
Authors: Harrison-Dening Karen
Published: September 2019

While patients diagnosed with dementia will require management from specialist neurology clinics, practice nurses play an important role in their health. Karen Harrison-Dening explains what assessment tools are available for patients with particular health needs

The majority of patients are diagnosed in a memory assessment service or a neurology clinic. However, early detection of a possible dementia is often done in a primary care setting. Dementia diagnosis has been seen by some as a ‘tick-box exercise’ but there are significant benefits to patients and their families when screening or testing for dementia is carried out early, especially in supporting the patients management of other comorbid or long-term conditions. Nurses working in primary care have a key role in identifying patients who may have the signs and symptoms of dementia by enabling them to access a timely diagnosis.
Technology-enabled care in practice: from apps to Skype
Authors: Johnson Kellie , Chambers Chris , Corden-LePetit Dena
Published: September 2019

As the demand for consultations increases, technology-enabled care may provide a viable solution. Kellie Johnson, Chris Chambers and Dena Corden-LePetit explore what technology is already available, including apps and Skype

With demand for consultations becoming ever greater in primary care, the ability to diversify and find smarter ways of working is crucial. Stepping outside of comfort zones and embracing new technology may be the first step in widening the consulting remit. Using apps can be a great way of introducing technology into the workplace and a means of building digital confidence in patients and health professionals. With the correct support and guidance, more clinicians are using opportunities to progress to more interactive applications in their practice, such as Skype.