bluuebunny/crossref_metadata_2025 huggingface dataset:
2201 Motivations for being informal carers of people living with dementia: an updated systematic review
Authors: Rajalingam M , Farina N , Hicks B
Published: January 2025

Background

Informal caregivers play a critical role in providing continuous, unpaid care to individuals with dementia, helping to improve their quality of life and reduce the demand on formal care services. The caregiving relationship is a complex, dyadic process that can have profound effects on both the caregiver and the care recipient, underscoring the need to alleviate caregiver burden and support their well-being. Understanding the motivations behind why individuals take on caregiving roles is essential, as it can predict their experiences, perceptions, and the overall impact of caregiving on their lives. A systematic review by Greenwood and Smith identified key motivators for informal caregivers. Additionally, there is substantial evidence that cultural perspectives and social values significantly influence caregiver experiences and motivations.

Methods

This systematic review aimed to update the findings of Greenwood and Smith by examining recent research on the motivations behind caregiving across different demographics, ethnicities, and cultures. Six electronic databases were searched from August 2018 to January 2024. Titles and abstracts were screened using machine learning methods (ASReview), and a subset of full texts underwent duplicate screening. Eligible studies were appraised using the Mixed Methods Appraisal Tool (MMAT), and data were extracted and organised into thematic categories.

Results

The initial search yielded 1843 articles, of which 37 studies met the inclusion criteria after deduplication and screening. Cultural explanations for caregiving motivations included themes such as familism, ethnic identity, cultural values and beliefs, a sense of obligation, and personal fulfilment.

Discussion

Cultural perceptions and social values play a significant role in shaping caregivers’ experiences and perceptions, which in turn influence families’ engagement with and acceptance of formal care and support services. These findings highlight the need for further research to guide the development of culturally sensitive psychosocial support interventions tailored for diverse caregiving populations. Such personalised approaches are essential for reducing caregiver burden and fostering an inclusive caregiving environment that respects the unique motivations and values of caregivers from various cultural backgrounds.
2875 The association between multiple long-term conditions, person- and disease-related factors and adverse inpatient outcomes
Authors: Nicholl BI , Bischoff E , Burton JK , Canning J , Wood K , Collard R , Hanlon P
Published: January 2025

Introduction

People living with multiple long-term conditions (MLTC) are more likely to experience hospital admission, which is often associated with unintended consequences. Preventing or providing alternatives to admission by predicting adverse admission-related outcomes is important. This study aims to provide an overview of the association between MLTCs and adverse outcomes following hospital admission through a systematic review of systematic reviews.

Method

We searched Medline, Embase, CINAHL, Web of Science and PsycINFO for systematic reviews assessing risk factors/predictors of functional decline (FD), nursing home admission (NHA), or changes in quality of life among adults (≥18 years) experiencing unscheduled acute hospital admission. Eligible reviews had to assess MLTC (LTC counts, indices, or individual LTCs), either alone or with other predictors. Titles/abstracts and full texts were screened in duplicate and candidate predictors were extracted.

Results

14 systematic reviews assessed predictors of FD (n = 8) or NHA (n = 6). Reviews focused on studies of general inpatients/mixed presentations (n = 8: 6 FD, 2 NHA); hip fracture (n = 2: 1 FD, 1 NHA); stroke (n = 2: 1 FD, 1 NHA) and cognitive impairment (n = 1, NHA) or delirium (n = 1, NHA). Assessment of MLTC was heterogenous: comorbidity indices (n = 4), counts of LTC (n = 2), specific LTC (n = 8), and ‘comorbidity’ without further qualification (n = 3). Higher comorbidity indices, higher counts, and a range of specific comorbidities (most notably dementia) were associated with FD and NHA. Reviews assessing MLTC alongside other predictors highlighted a broad range of sociodemographic, functional, social, and admission-related factors that were associated with FD and NHA. In general, reviews did not assess the relative importance of MLTC alongside other predictors.

Conclusion

While MLTC may predict unwanted outcomes following admission their qualification is often inconsistent and their relative importance as predictors, alongside broader factors such as social complexity, is rarely assessed in existing systematic reviews.
2832 Understanding the experiences of older residents required to relocate from one nursing home to another: a qualitative study
Authors: Yau SY , Lee YK , Pang CK , Fitzpatrick JM , Harris R , Wan MW , Chan SH
Published: January 2025

Introduction

As a response to the increased demand for nursing home services for older adults, there are new initiatives include building larger nursing homes to accommodate greater numbers of residents. This initiative can be detrimental to those older residents who required to be relocated from their current nursing home to a new one. However, there is limited understanding about how older residents adapt to this relocation, particularly on how they tackle the various issues after relocation. Thereby hindering healthcare personnel to identify appropriate strategies to support older residents during the process of relocation. The aim of this poster is to present the experiences of older residents in the immediate period after relocating to a new nursing home.

Method

A descriptive qualitative approach was adopted. Purposive sampling was used to recruit twenty-four older residents, who were relocated from existing nursing home to a new nursing home, upon ethical approval was sought. Semi-structured interviews were conducted based on the ‘process of adjustment’ framework after consent was obtained. Each interview lasted for around thirty minutes and audio-recorded. Data were analysed using thematic analysis.

Results

Four themes were identified namely: adaptation to the new environment, interaction with other residents, interaction with healthcare personnel, and changes to their daily life. In particular, participants highlighted changes to their daily routines and interactions with others, but most of them expressed positivity about their relocation to the new nursing home.

Conclusion

The results illuminate the initial experiences of older residents required to relocate from their nursing ‘home’ to another with no choice. These findings will inform further interviews over time to help inform person-centred care for residents, the role of carers and service providers, and the care environment.

Acknowledgement

The work described in this paper was fully supported by Hong Kong Metropolitan University Research Grant (No. RD/2023/1.18).
2882 Frail2Fit study: a feasibility and acceptability study of an intervention delivered by volunteers to improve frailty
Authors: Meredith SJ , Holt L , Grocott MPW , Jack S , Murphy J , Varkonyi-Sepp J , Bates A , Lim SER
Published: January 2025

Introduction

Physical activity (PA) and replete nutritional status are key to maintaining independence and improving frailty status among frail older adults. We aimed to evaluate the feasibility and acceptability of training volunteers to deliver a remote intervention, comprising exercise, behaviour change, and nutrition support, to older people with frailty after a hospital stay.

Methods

Volunteers were trained to deliver a 3-month, multimodal intervention to frail (Clinical Frailty Status ≥5) adults ≥65 years after hospital discharge, using telephone, or online support. Feasibility was assessed by determining the number of volunteers recruited, trained, and retained; participant recruitment; and intervention adherence. Interviews were conducted with 16 older adults, 1 carer, and 5 volunteers to explore intervention acceptability. Secondary outcomes included physical function, appetite, well-being, quality of life, anxiety and depression, self-efficacy, and PA. Outcomes were measured and compared at baseline, post-intervention, and follow-up (3-months). Interviews were transcribed verbatim and analysed using thematic analysis.

Results

Five volunteers (mean age 16, 3 female) completed training, and 3 (60%) were retained at the end of the study. Twenty-seven older adults (mean age 80 years, 15 female) signed up to the intervention (10 online; 13 telephone). Seventeen completed the intervention. Participants attended 75% (IQR 38–92) online sessions, and 80% (IQR 68.5–94.5) telephone support. Self-reported total PA (p = 0.006), quality of life (p = 0.04), and appetite (p = 0.03) improved significantly post-intervention, with a non-significant decrease at follow-up. The intervention was safe and acceptable to volunteers, and older adults with frailty. Key barriers were lack of social support, and exercise discomfort. The online group was a positive vicarious experience, and telephone calls provided reassurance and monitoring to socially isolated older adults.

Conclusion

Volunteers can safely deliver a remote multimodal intervention for frail older adults discharged from hospital with training and support from a health practitioner.
2768 Needs of people with dementia in the perioperative environment from the perspective of healthcare professionals
Authors: Diaz A , Kozlowska O , Pendlebury S
Published: January 2025

Introduction

The incidence of dementia among patients in perioperative settings is on the rise, presenting significant challenges for healthcare professionals in delivering adequate and appropriate care to this patient population. In order to gain a deeper understanding of the perioperative care needs of patients with dementia, thirty healthcare professionals were interviewed. The focus was on their experiences and perspectives regarding the fulfilment of these needs. Key factors influencing perioperative care were identified and categorised into three main themes: patient-related factors, healthcare professional-related factors, and healthcare environment-related factors.

Methods

Thirty interviews were conducted with a diverse group of healthcare professionals, including anaesthetists, surgeons, nurses, and other perioperative staff. Thematic analysis was employed to process and interpret the data, identifying recurring themes and sub-themes that reflect the complexities of perioperative care for patients with dementia.

Results

The analysis revealed three primary themes: 1) Factors related to the patient with dementia: Cognitive impairment and comorbidities uniquely challenge perioperative care. The unfamiliar hospital environment often exacerbates cognitive symptoms, and adherence to postoperative protocols can be problematic. Family involvement is crucial in supporting these patients. 2) Healthcare Professional Factors: Perceptions of dementia, communication issues, pain assessment, and the need for personalised care were highlighted. Training and education deficits among healthcare professionals were evident, impacting the quality of care. 3) Institutional Factors: Organisational policies and resource allocation significantly affect the provision of dementia care. Support for healthcare professionals through ongoing education and the development of dementia-specific guidelines were identified as essential needs.

Conclusion

Effective perioperative care for patients with dementia requires addressing multifaceted challenges. Improving communication, enhancing education and training for healthcare professionals, involving family members, and ensuring institutional support are critical steps. A comprehensive, empathetic approach can lead to better outcomes and experiences for patients with dementia in the perioperative setting.
2873 Post traumatic stress disorder in older adults after delirium: a systematic review
Authors: Narayanasamy S , Muchenje N , McColl A
Published: January 2025

Introduction

Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by frightening or traumatic events. Delirium is a state of acute confusion associated with acute illness, surgery, and hospitalisation. Delirium is known to be associated with a risk of PTSD in patients in the Intensive Care (ICU) setting. However, there is limited information on the prevalence of delirium in older adults outside of Intensive Care. We therefore undertook a systematic review to ascertain the prevalence of PTSD in elderly patients after an episode of delirium on a general ward.

Methods

The systematic review was conducted using MEDLINE (1946–10/01/2024), Embase (1974–10/01/2024), and PsycINFO (1806–10/01/2024) to identify studies. Studies were eligible if they included adults aged ≥65 years, admitted to an acute hospital, diagnosed with delirium using a validated screening tool, (e.g. 4AT, CAM-ICU) and subsequently screened for PTSD at any point following discharge with a validated screening tool (e.g. the PTSS-14). The exclusion criteria excluded ICU cohorts and terminal illness with <3 months life expectancy. Two researchers (SM, NM) independently reviewed all studies with any disparities resolved through a 3rd researcher (AM).

Results

After removal of duplicates, the search identified 1042 titles from which only 3 eligible studies were identified. All 3 studies were in older patients after surgical procedures (n = 132 participants in total). Two of the studies reported no association between delirium and the subsequent risk of PTSD. However, the largest study (n = 77) reported a significant independent association between delirium and the 3-month risk of PTSD.

Conclusion

The current body of research on the prevalence of PTSD following episodes of in-patient delirium in older adults is limited. The findings of this review highlight the need for further research. A prospective cohort study on Geriatric Medicine wards is being planned.
2796 Improving physical health care in older people in mental health settings: the ImPreSs-care qualitative study
Authors: Hickey B , Desai B , Davies F , Chari D , Evley R , Clegg C , Donovan A , Rajkumar AP , Dening T , Subramaniam H , Mukaetova-Ladinska E , Robinson T , Tarrant C , Beishon L
Published: January 2025

Background

The overlap between physical and mental health is a common challenge for older adults, and many live with co-occurring physical and mental health disorders. Different service models have been adopted; however, the majority provide specialist mental health input to older adults with physical health needs in acute hospital trusts. Few service models are available providing comprehensive physical health input to older adults in secondary mental healthcare settings. Furthermore, little information is available regarding specific physical healthcare needs facing older people receiving specialist mental healthcare. The aim of this qualitative study was to determine the facilitators and barriers to delivering physical healthcare for older adult patients, their carers, and staff within specialist mental health settings (inpatients and community).

Methods

54 semi-structured interviews (REC:22/IEC08/0022) were conducted with different stakeholders (staff (n = 28), patients (n = 7), carers (n = 19)) across two mental health trusts (Leicester, Nottingham). Interviews explored the facilitators and barriers to delivering physical healthcare to older people (aged >65 years) receiving secondary mental healthcare (dementia and functional disorders) with combined physical health needs. Interviews were audio recorded and transcribed verbatim. Data were analysed thematically, drawing on an underpinning framework of integrated care for individuals with multimorbidity (SELFIE).

Results

Three main themes were identified: 1) service delivery; focussing on care coordination and communication between services, 2) workforce; focussing on training and skills alongside support and availability of physical health expertise, 3) the individual with multimorbidity; focussing on mental-physical health interplay and patient experience.

Conclusions

The findings from this study can be used to inform service development to improve the provision of physical healthcare for older people receiving secondary mental healthcare in the UK, focussing on improving care coordination and communication between physical and mental health services, and upskilling and training mental health teams in physical health provision with appropriate support from physical health experts.
Coagulation abnormalities following brown recluse spider (Loxosceles reclusa) envenomation: A description of 2 cases and review of the literature
Authors: Hart Stephanie A , Gailani David , Bibb Lorin A , Zwerner Jeffrey P , Booth Garrett S , Jacobs Jeremy W
Published: January 2025

Objective

Hemostatic abnormalities, including disseminated intravascular coagulation (DIC), are often cited as a common finding in patients following Loxosceles spider envenomation (ie, loxoscelism). The prevalence and severity of coagulopathy, however, particularly following L reclusa (ie, brown recluse) envenomation, is not well described. This study aimed to characterize coagulation laboratory parameters and coagulopathy in patients following L reclusa envenomation.

Methods

We evaluated the coagulation laboratory parameters (eg, prothrombin time, partial thromboplastin time, coagulation factor activity levels, lupus anticoagulant [LA] testing) of 2 patients seen at our institution following brown recluse spider envenomation. We also comprehensively reviewed the literature for all reported cases of brown recluse spider envenomation and assessed patient demographics, clinical presentations, coagulation laboratory parameters, and outcomes.

Results

We identified 2 patients with loxoscelism (1 cutaneous only, 1 systemic with hemolysis) with prolonged partial thromboplastin times but with normal clotting factor levels following envenomation. Literature review identified 263 patients: 12 patients had at least 1 prolonged clotting time, 31 reported a platelet count below 150 × 109/L, and there was clinical concern for DIC in 12 cases. The odds of death were statistically significantly higher in patients with clinical concern for DIC than in cases without concern for DIC or coagulopathy (odds ratio, 82.9 [95% CI, 12.6-433.8]; P < .001).

Conclusions

Following brown recluse spider envenomation, hemostatic perturbations are infrequent and clinical coagulopathy is uncommon, but the odds of death following a brown recluse spider bite are statistically significantly greater if DIC develops, even when compared to individuals with hemolysis without DIC.
Keynes and the Provincial investment problem
Authors: Woods J E
Published: January 2025

From early 1924 until his death in 1946, Keynes was actively involved in managing the assets of the Provincial Insurance Company, based in Kendal, Westmorland. From 1940, increasing responsibilities advising the UK Government meant a gradual reduction in day-to-day management activities, his replacement being Ian Macpherson, the senior partner of the London stock-broking firm, Buckmaster & Moore, who was well known to both Keynes and F. C. Scott, The Provincial’s managing director. The Provincial materials reproduced in Chapter 1 of Volume XII of The Collected Writings suggest increasing differences of opinion between them on investment policy from the late 1930s. A review of their correspondence in the Keynes Archive at King’s College, Cambridge, demonstrates that such differences were more serious than previously understood, with Scott imposing a significant change to Keynes’ policy in 1942 by creating the low-volatility Stable Fund accounting for 40% of total assets. Eventually, in mid-1944, this change presented Macpherson with a problem he described to Keynes as ‘most intractable’ and also involved him telling Keynes that Scott ‘does not understand the elementary principles and theory of investment’. In this article, we review Keynes’ relationship with The Provincial, tracing the development of this ‘most intractable problem’ by means of three Case Studies, which provide insights into not only his role at The Provincial but also the principles underlying the unconventional, oblique investment approach he practised in the 1930s and 1940s, as distinct from his credit cycling policy of the 1920s.
COVID-19 among Kidney Transplant Recipients: Evaluating Risk Factors During the Initial Phase of the Pandemic
Authors: Nowak Alexandra , Caldinelli Aurora , Segelmark Mårten , Rydell Helena , Artborg Angelica , Bellocco Rino , Stendahl Maria , Lindholm Bengt , Wijkström Julia , Evans Marie
Published: January 2025

Background

Current knowledge about risk factors for severe COVID-19 among kidney transplant recipients stem from meta-analyses of small or regional studies.

Methods

All kidney transplant recipients in Sweden as of January 1, 2020 (n = 5 824) were followed during the first two years of the pandemic. Data from the Swedish Renal Registry and linked health care registries were analysed by multivariable adjusted logistic regression to identify risk factors for severe COVID-19, defined as hospitalization or death due to COVID-19.

Results

Male sex increased the risk of severe COVID-19. While many comorbidities were associated with increased risk, their significance diminished after adjustment for other factors. Kidney transplant recipients of working age, 49–58 years adjusted odds ratio (aOR) 2.32 (95% CI 1.53–3.51) and 59–68 years aOR (1.92; 1.26–2.91) had the highest risk compared to the youngest age group (18–38 years). Compared to recently (<1 year) transplanted patients, those transplanted more than 5 years ago had lower the risk of severe COVID-19 (aOR 0.52; 0.36–0.75 for 6–10 years; aOR 0.57; 0.41–0.79 for > 10 years). Longer pre-transplant dialysis vintage (aOR1-year 1.04; 1.01–1.06) and deceased donor kidneys (aOR 1.41; 1.09–1.84) increased the risk. Immunosuppression with mycophenolate mofetil (aOR 1.47, 95% CI 1.08–1.99) and proton pump inhibitor use (aOR 1.58, 95% CI 1.24–2.01) was strongly associated with severe COVID-19.

Conclusions

While kidney transplant recipients share risk factors with the general population, working age groups were at the highest risk- unlike in the general population. These findings emphasize the need for targeted prevention and treatment strategies for kidney transplant recipients in future pandemics.
Prevalence and Correlates of Social Isolation Among Older Adults in Subsidized Housing
Authors: Wu Richard , Pomeroy Mary Louise , Prichett Laura , Duchen Jessica , Runge Katherine , Andes Laura , Williams Nicole , Thorpe Roland J , Latkin Carl , Boyd Cynthia , Cudjoe Thomas K M
Published: January 2025

Background and Objectives

Social isolation is an increasing public health concern. Older residents in subsidized housing may be susceptible to isolation given high rates of chronic illness/disabilities, low income, and living alone. This cross-sectional study examined correlates of social isolation among over 3,000 older adults from nearly 100 subsidized housing communities across the US.

Research Design and Methods

Respondent Lubben Social Network Scale-6 scores, demographic data, and health information were collected in 2019 by a non-profit housing organization and linked to the Neighborhood Atlas Area Deprivation Index. Associations between social isolation and other variables were assessed using logistic regression.

Results

The mean respondent age was 75.9 years; 67% were female, 33% were male, 38.8% were white, 15.5% were Black, 7.8% were Hispanic, and 27.5% were Asian. Among all respondents, 29.8% were isolated. Adjusting for demographics, multi-level logistic regressions demonstrated significant associations between isolation and poor self-rated health, functional impairment, mental health distress, and knowing/relying on fewer neighbors.

Discussion and Implications

This study sheds light on the prevalence and correlates of social isolation among older adults who live in subsidized housing managed by a large non-profit housing organization. The findings from this study suggest that contextual and structural factors must be further investigated to better understand social isolation among older subsidized housing residents. Ultimately, this work informs efforts to identify socially isolated older adults and evidence-based interventions to address this public health concern.
The association between oxidative stress and risk of sarcopaenia: a Mendelian randomisation study
Authors: Ma Yiqin , Yang Dan , Zhao Xiaoxuan , Wang Rongyun
Published: January 2025

Objective

This study aimed to evaluate the causal link between oxidative stress and sarcopaenia using Mendelian randomisation.

Methods

Instrumental variables (IVs) at the genome-wide significance level were gathered from a published summary database, and the inverse variance weighted approach and many other Mendelian randomisation (MR) methods were used to assess the causal relationship between oxidative stress and risk of sarcopaenia.

Results

Inverse variance weighting analysis showed absolute α-tocopherol levels and absolute circulating retinol levels had a direct causal effect on handgrip strength. In addition, walking pace was linked to genetically predicted circulating α-tocopherol and superoxide dismutase (SOD). However, genetically predicted oxidative stress-related characteristics did not exhibit any causal relationship with appendicular lean mass.

Conclusions

Our findings indicate that α-tocopherol and retinol boost grip strength and life quality in sarcopenia. Despite affecting walking pace, SOD's protection suggests gait speed can improve with antioxidant adjustments.
Direct economic costs related to antimicrobial resistance in bloodstream infections isolated from newborns in a perinatal hospital in Peru
Authors: Pons Maria J , Quispe Antonio M , Tirado Miguel , Soza Gabriela , Ruiz Joaquim
Published: January 2025

Background

Antimicrobial resistance (AMR) has emerged as a priority for both public health and the global economy. Moreover, information on AMR is scarce, particularly in low/middle-income countries. We evaluated the direct economic cost of microorganisms and AMR.

Methods

We performed a cross-sectional study to assess the economic costs of neonatal cases diagnosed with bacteremia at the Instituto Nacional Materno Perinatal in Lima, Peru, from January 2017 to June 2018. We used cost invoices calculated by the micro-costing bottom-up approach, as well as the strain identification and antimicrobial susceptibility data, to estimate the direct costs.

Results

The average costs of bacteremia were US$349 (SD 403) for multidrug-resistant (MDR) strains and US$276 (SD 349) for non-MDR strains. Costs were higher for microorganisms associated with late-onset sepsis (LOS). We found that LOS, multidrug resistance and age were significantly associated with bloodstream infection (BSI) costs. Also, all microorganism groups were associated with increased costs, with the highest average costs for Acinetobacter, followed by Pseudomonas.

Conclusions

In Peru, BSI costs are strongly associated with AMR. Furthermore, costs increase significantly with LOS, multidrug resistance and the patient's age. We urge health authorities to strengthen measures and strategies against the pressing threat of AMR.
A Reconception of Power in Competition Law with Its Application in the Digital Realm
Authors: Li Liang
Published: January 2025

As a fundamental concern of competition law, the concept of power remains inadequately understood. The limitations have become increasingly evident in the digital economy realm where new challenges have often not been addressed promptly, coherently, and effectively. Although new theories and analytical tools have been proposed, they frequently result in overlaps and gaps. There is a pressing need to establish a more coherent theoretical foundation that integrates traditional and emerging theories of power. Tapping into legal philosophy and global empirical evidence, this article proposes a reconceptualization of power as an overarching theoretical framework. This reconceptualization differentiates between power as capacity and its exercise, classifies the various forms of power exertion, and identifies several distinct types of power. The reconceptualization elucidates how different types of power—such as economic, political, informational, and technological—all contribute to power dynamics in markets. By broadening the dimensions of power analysis in competitive assessment, the proposed understanding of power frees legal discourse from the limitations of a purely economic perspective. The Facebook/WhatsApp merger is analysed as an illustration. However, the proposed conception is also relevant for assessing other competitive issues, such as the power interplay between economic and noneconomic factors like privacy and personal data protection, and democracy.
Group Cognitive Behavioral Therapy for PTSD
Authors: Beck J. Gayle
Published: January 2025

Group Cognitive Behavioral Therapy (CBT) for PTSD: Therapist Guide provides session by session guidance for clinicians to deliver Cognitive Behavior Therapy (CBT) in a group setting to clients with PTSD. It overviews best practices derived from group therapy literature, with evidence-based cognitive behavioral approaches targeting PTSD and frequently co-occurring conditions. The co-occurring conditions include depression, anxiety, and social isolation. Moreover, Group CBT has been tested and shown to reduce symptoms of PTSD and improve quality of life, overall functioning, and life satisfaction. The Therapist Guide also offers helpful notes and worksheets dedicated to each session based on the clinical experience working with people with PTSD.
Session 1: Education About PTSD and Group CBT
Authors: Beck J. Gayle
Published: January 2025

This chapter outlines the basic information that therapists should provide to clients who are beginning group cognitive behavioral therapy for posttraumatic stress disorder (PTSD). Group CBT is based on a structured approach to treatment, designed to help clients build skills for handling posttrauma problems and develop a better sense of control. Therapists should explain how trauma can develop into PTSD. This chapter provides an overview of the treatment program, introducing a series of skills designed to help clients cope with problems related to the trauma. The therapists should emphasize the importance of maintaining confidentiality so that clients can discuss their feelings openly.
Session 10: Addressing Anger (Part II)—Using a Behavioral Approach
Authors: Beck J. Gayle
Published: January 2025

This chapter discusses the session on how to address anger through a behavioral approach. It highlights how the process of suppressing anger often leads to perceptions and beliefs that contribute to chronic negative emotions. The chapter then details the process of asking group members about the success of exposure practices and the A-B-C-D approach. It then introduces assertiveness as a useful behavioral tool to reduce anger and also guide productive interactions when a client is asking someone to change their behavior. Assertiveness refers to the ability to stand up for one's rights, opinions, needs, and feelings without infringing on others.
Session 11: Feeling Down—How to Fight It
Authors: Beck J. Gayle
Published: January 2025

This chapter explains techniques clients can use to fight depression. Some individuals with posttraumatic stress disorder (PTSD) have difficulty acknowledging feelings of depression, as these feelings are interpreted as a sign of weakness. Normalizing depression is important in the context of group cognitive behavioral therapy (CBT), particularly when working with clients who have chronic PTSD. The chapter introduces pleasant activity scheduling, which rests on the idea that there is an imbalance between negative and positive outcomes in the client’s interactions with their environment. The goal is to increase both the quantity and quality of pleasant activities in the client’s life.
Session 13: Planning for the Future
Authors: Beck J. Gayle
Published: January 2025

This chapter describes the importance of developing coping plans for the future after the program ends. Many clients fear that without the support of the group, they will lose the gains they have made during treatment. Becoming aware of potential risk situations will help clients to be prepared if that circumstance comes along; will help clients to anticipate their reactions, thus not leaving them feeling out of control; and will help clients to ensure that a lapse does not turn into a relapse. The therapists will explain the difference between a lapse and a relapse. The chapter provides an overview of the general principles of coping with stress and PTSD-related symptoms.
Session 14: Wrapping Up Group CBT
Authors: Beck J. Gayle
Published: January 2025

This chapter outlines the final session of this program. Since recovery from posttraumatic stress disorder (PTSD) is a process, facilitators should remind clients that the road ahead is best viewed as a journey. Change is rarely linear when it comes to treatment gains, which is something that clients have likely experienced throughout the course of Group CBT. It is normal to still be troubled by the trauma, but this event should not be the guiding force in clients’ lives. Clients should use the coping plans they have developed to remind themselves that they have the skills and the power to address any PTSD symptoms that recur. The chapter then reviews the specific skills covered in this program.
Session 1: Education About PTSD and Group CBT
Authors: Beck J. Gayle
Published: January 2025

This chapter provides education about posttraumatic stress disorder (PTSD) and group cognitive behavioral therapy (CBT) treatment. Group CBT is based on a structured approach to treatment, designed to help you and all the other Veterans in the group build skills for handling posttrauma problems. Moreover, Group CBT involves a small group of Veterans who have experienced at least one traumatic life event and are struggling with the symptoms of PTSD. The chapter provides information about the symptoms of PTSD and describes skills to be learned during the Group CBT program. The importance of confidentiality during the program is emphasized, so the group can be a safe, trusted space.
Session 6: Working with Your Thoughts (Part I)—Coping Self-Statements
Authors: Beck J. Gayle
Published: January 2025

This chapter discusses the importance of thoughts and how thoughts drive our emotions, moods, behaviors, and physical well-being. In this session, Veterans are taught to work with their thoughts, beginning with coping with self-statements. The chapter explores techniques to address negative self-talk and use coping self-statements before, during, and after a stressful event. Coping self-statements can be learned and can challenge the stream of negative self-talk that is common among individuals with PTSD.
Session 8: Working with Your Thoughts (Part III)—Changing the Cycle of Thoughts and Feelings
Authors: Beck J. Gayle
Published: January 2025

This chapter provides Veterans with information about how to change the cycle of thoughts and feelings. It introduces the A-B-C-D approach to help Veterans s learn how to uncover and address their negative beliefs, which are central assumptions people hold about themselves and the world. These negative beliefs tend to get woven into thought processes and influence many different aspects of people's daily lives. The chapter highlights the importance of the downward arrow technique, which slows thinking down and helps clients to examine what the negative thought means to them. It also highlights how the three cognitive skills introduced in this program are different but still complement one another.
Session 10: Addressing Anger (Part II)—Using a Behavioral Approach
Authors: Beck J. Gayle
Published: January 2025

This chapter explores how Veterans can address their anger using a behavioral approach. Triggers for anger vary between people and may be an event or other people's actions. Learning how to be assertive and ask for what is needed is a useful behavioral tool that can guide helpful interactions when asking someone to change their behavior. Assertion is the ability to stand up for one's rights, opinions, needs, and feelings without infringing on other people. The chapter offers practical steps on how to be assertive in different situations, pointing out that the other party may not agree to change their behavior. It also offers details on problem-solving as a means to manage anger.
Session 13: Planning for the Future
Authors: Beck J. Gayle
Published: January 2025

This chapter discusses planning for the future after the program ends and suggests ways to manage PTSD symptoms so that a lapse does not become a relapse. Avoidance and other PTSD symptoms limit a person's life, but with awareness and planning people can live their lives without limits. Being aware of risks can help clients to make the transition out of the program. Veterans need to be mindful of being stressed again by specific types of situations and cues. The chapter provides an overview of the general principles of coping with stress, which is a form of action designed to reduce dangers, correct misperceptions, or achieve a planned goal.
Stressors and Support Experienced by Active Duty U.S. Navy Sailors at Sea
Authors: Hurtado Lauren M , Harrison Elizabeth M , Englert Robyn M , Perez Vanessa G , Thomsen Cynthia J , Schmied Emily A
Published: January 2025

Introduction

High occupational stress is generally associated with poorer mental health and reduced performance in military personnel, whereas access to support resources is associated with positive outcomes. However, little research has examined the unique stressors and supports experienced by sailors on ships while underway at sea. The objectives of this study were to (1) identify sailors’ underway stressors and supports and (2) examine how these differ as a function of demographic and operational factors.

Materials and Methods

Active duty U.S. Navy sailors reporting an underway period lasting at least 30 days within the last 5 years (n = 441; 74.7% male, 90% enlisted) completed an anonymous retrospective survey. Sailors completed measures assessing underway stressors (25 items) and supports (9 items), as well as demographic, military, and operational characteristics (sex, rank, ship type, and underway duration). The study protocol was approved by the Naval Health Research Center Institutional Review Board in compliance with all applicable federal regulations governing the protection of human subjects.

Results

Overall, the stressors rated as most problematic were exposure to loud noises, inability to rest when needed, unavailability of quality mental and physical health care, and not having enough people to complete the mission. Sailors perceived the most available supports to be opportunities to socialize, safety while performing duties, and finding ways to relieve stress. Female and enlisted personnel, relative to male and officer personnel, respectively, generally perceived stressors as more problematic and support resources as less available. Nearly half of the sample (48.3%) reported that services and programs to help them deal with stress while at sea were inadequate.

Conclusion

Sailors experience many stressors while underway. Increasing the resources available to underway sailors may be warranted, especially for female and enlisted personnel. Additional research is necessary to develop targeted interventions and resources. Possible recommendations include noise mitigation, berthing area improvements, sleep and/or scheduling interventions, improved access to mental and physical health care, and interventions to reduce the stigma associated with seeking mental health care.
When Prophecy Fails: The Case of the Satmar Rebbe, the Six-Day War, and the Book Al Ha-Geula Ve-Al Ha-Temura
Authors: Keren-Kratz Menachem
Published: January 2025

The term “Cognitive Dissonance” describes a psychological process that aims to reduce mental tension between conflicting understandings. Such conflicts happen, for example, when an individual or a group discovers that certain events contradict previous assumptions or beliefs. The greater the gap between reality and the presupposition, the greater the dissonance. So, when a fundamental religious belief is confronted with facts that seem to totally contradict it, there is a tremendous psychological pressure to find a way to alleviate that tension. This article reviews how the Satmar Rebbe reacted after realizing that his greatest fundamental beliefs were contradicted by a series of historical happenings. On the one hand, he wholeheartedly believed that Zionism was a great sin that forced God to punish His beloved people with the Holocaust. On the other hand, however, it appeared that God not only allowed the establishment of Israel, the pinnacle of the Zionist quest, but also blessed it with success to overcome the many obstacles it faced during its early years. Israel’s greatest achievement was its outstanding victory in the Six-Day War and the liberation of the holy places in Jerusalem’s old city. This article examines how the Satmar Rebbe sought to resolve the discrepancy between his fierce anti-Zionist stance and Israel’s triumph that even the Haredim believed was a heavenly miracle.
Incidence of ANCA associated vasculitis and polyarteritis nodosa in Norfolk, UK, from 2011-2020
Authors: Fordham Sarah , Ashurst Karen , Bartoletti Alice , Coath Fiona L , Ducker Georgina , Kamath Ajay , Mushtaq Warda , Naeem Hassan , Nicholls Isabelle , Sheehy Claire , Sisson Katherine , Watts Richard , Mukhtyar Chetan B
Published: January 2025

Objective

To report the annual and age-specific incidence of ANCA associated vasculitis and polyarteritis nodosa in the adult population of Norfolk County, UK.

Methods

Individuals newly diagnosed with ANCA associated vasculitis or polyarteritis nodosa between 1st Jan 2011 and 31st December 2020, residing in the postal areas of NR1-NR30 were included. Patients were classified according to the European Medicines Agency algorithm. Population data were available from the Office of National Statistics, UK.

Results

164 patients were diagnosed with ANCA associated vasculitis or polyarteritis nodosa over 4.7-million-person years. The annual incidence (95% CI) of ANCA associated vasculitis was 34.3 (29.2, 40)/million person years. The annual incidence for granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis was 18.9 (15.2, 23.3), 12.8 (9.7, 16.4), and 2.6 (1.3, 4.5)/million person years respectively. The annual incidence for polyarteritis nodosa was 0.6 (0.1, 1.9)/million person years. The age specific incidence of granulomatosis with polyangiitis and microscopic polyangiitis rose with each decade of life and was highest in the 8th decade for granulomatosis with polyangiitis (53.2 (95% CI 36.2, 75.6) per million) and in the 9th decade for microscopic polyangiitis (48.4 (95% CI 27.1, 79.8) per million).

Conclusions

The incidence of ANCA associated vasculitis, specifically that of granulomatosis with polyangiitis and microscopic polyangiitis is slowly rising over time. It is most notable amongst the elderly population where incidence rates for granulomatosis with polyangiitis and microscopic polyangiitis peak. There may be a 4-year incidence cycle which needs confirmation in a longer study.
A multi-omics study of the association between insomnia with objective short sleep duration phenotype and high blood pressure
Authors: Dai Yanyuan , Vgontzas Alexandros N , Chen Le , Zheng Dandan , Chen Baixin , Wu Jun , Shao Ruifan , Li Yun
Published: January 2025

Study Objectives

Insomnia with objective short sleep duration is associated with increased hypertension risk. We aimed to explore the mechanism underlying the association between objective short sleep duration and hypertension in patients with chronic insomnia disorder (CID) by multi-omics.

Methods

CID was defined according to International Classification of Sleep Disorders-3, and objective short sleep was based on the median value of total sleep time of the overall subjects during an overnight polysomnography. We used the mean values of measured nighttime and morning systolic (SBP) and diastolic blood pressure (DBP) for analysis. Serum metabolomics and fecal 16S rDNA amplicon sequencing were used to explore characteristic metabolites and analyze gut microbiota distribution, respectively.

Results

One hundred three patients with CID and 70 normal sleepers were included. We found 52 objective short sleep duration insomnia phenotype (ISSD)-related serum metabolites. Among the 52 ISSD-related serum metabolites, indoxyl sulfate was positively correlated with BP after adjusting for confounding factors (SBP: β=0.250, p=0.028; DBP: β=0.256, p=0.030) in ISSD. In addition, the level of serum indoxyl sulfate was significantly correlated with the genera Prevotella 9 (r=0.378, p=0.027), CAG-56 (r=-0.359, p=0.037), Ruminiclostridium 9 (r=-0.340, p=0.049) and Ruminococcus 2 (r=-0.356, p=0.039) in ISSD.

Conclusions

Our study suggests that the ISSD phenotype is associated with significant changes in serum metabolic profile, including high levels of indoxyl sulfate. The latter molecule correlates both with BP and gut microbiota in patients with the ISSD phenotype, suggesting that indoxyl sulfate may be the molecular path resulting in increased hypertension risk in this phenotype.
Effectiveness of Selected Fungicides for Control of Powdery Mildew of Pumpkin in Central Illinois, 2024
Authors: Babadoost Mohammad , Pandey Krishna Raj , Redhu Sahil
Published: January 2025

This study was conducted in Champaign, Illinois to evaluate the efficacy of selected fungicides for control of powdery mildew of pumpkin, caused by the fungus Podosphaera xanthii. Seeds of jack-o-lantern pumpkin ‘Howden’ were sown on 31 May. The plots were spaced 30 ft apart in a randomized complete block design with four replications. Applications of fungicides, at 7-day intervals, began on 22 July and ended on 26 August. Severity of powdery mildew (percent total area of vines and leaves affected) was visually assessed at weekly intervals, beginning 14 July. Plots were harvested on 15 September. Powdery mildew was first observed on vines and leaves in the plots on 21 July. Severity of the disease was significantly (P = 0.05) higher in unsprayed plots compared to sprayed plots. The lowest AUDPC of powdery mildew was in the plots sprayed with Quintec plus Kocide-3000 alternated with Inspire Super plus Kocide-3000.