bluuebunny/crossref_metadata_2025 huggingface dataset:
Extending electronic medical records vector models with knowledge graphs to improve hospitalization prediction
Authors: Gazzotti Raphaël , Faron Catherine , Gandon Fabien , Lacroix-Hugues Virginie , Darmon David
Published: February 2022

Background

Artificial intelligence methods applied to electronic medical records (EMRs) hold the potential to help physicians save time by sharpening their analysis and decisions, thereby improving the health of patients. On the one hand, machine learning algorithms have proven their effectiveness in extracting information and exploiting knowledge extracted from data. On the other hand, knowledge graphs capture human knowledge by relying on conceptual schemas and formalization and supporting reasoning. Leveraging knowledge graphs that are legion in the medical field, it is possible to pre-process and enrich data representation used by machine learning algorithms. Medical data standardization is an opportunity to jointly exploit the richness of knowledge graphs and the capabilities of machine learning algorithms.

Methods

We propose to address the problem of hospitalization prediction for patients with an approach that enriches vector representation of EMRs with information extracted from different knowledge graphs before learning and predicting. In addition, we performed an automatic selection of features resulting from knowledge graphs to distinguish noisy ones from those that can benefit the decision making. We report the results of our experiments on the PRIMEGE PACA database that contains more than 600,000 consultations carried out by 17 general practitioners (GPs).

Results

A statistical evaluation shows that our proposed approach improves hospitalization prediction. More precisely, injecting features extracted from cross-domain knowledge graphs in the vector representation of EMRs given as input to the prediction algorithm significantly increases the F1 score of the prediction.

Conclusions

By injecting knowledge from recognized reference sources into the representation of EMRs, it is possible to significantly improve the prediction of medical events. Future work would be to evaluate the impact of a feature selection step coupled with a combination of features extracted from several knowledge graphs. A possible avenue is to study more hierarchical levels and properties related to concepts, as well as to integrate more semantic annotators to exploit unstructured data.
Introduction and expression of PIK3CAE545K in a papillary thyroid cancer BRAFV600E cell line leads to a dedifferentiated aggressive phenotype
Authors: Pinto Nicole , Ruicci Kara M. , Khan Mohammed Imran , Shaikh Mushfiq Hassan , Zeng Yu Fan Peter , Yoo John , Fung Kevin , MacNeil S. Danielle , Mendez Adrian , Mymryk Joe S. , Barrett John W. , Boutros Paul C. , Nichols Anthony C.
Published: February 2022

Anaplastic thyroid cancer (ATC) is a rare, aggressive form of undifferentiated thyroid cancer, which exhibits rapid progression and is almost universally fatal. At least a subset of ATC is thought to arise from pre-existing well-differentiated thyroid cancer, most frequently papillary thyroid cancer (PTC). While PIK3CA mutations are rare in PTC, they are common in ATC and tend to co-occur with BRAF mutations. This provided the rationale for our study to identify the potential role of PIK3CA mutations in the progression from well-differentiated to undifferentiated thyroid cancer. We introduced PIK3CAE545K into the LAM1 PTC cell line, which carries a BRAFV600E mutation. In culture, the engineered cell line (LAM1: PIK3CAE545K) proliferated faster and demonstrated increased clonogenic potential relative to the parental line carrying an empty vector (LAM1EV). Both the LAM1EV and LAM1: PIK3CAE545K edited lines were implanted into hind flanks of athymic nude mice for in vivo determination of disease progression. While tumour weights and volumes were not significantly higher in LAM1: PIK3CAE545K mice, there was a decrease in expression of thyroid differentiation markers TTF-1, thyroglobulin, PAX8 and B-catenin, suggesting that introduction of PIK3CAE545K led to dedifferentiation in vivo. Collectively, this study provides evidence of a role for PIK3CAE545K in driving disease progression from a well-differentiated to an undifferentiated thyroid cancer; however, over-expression was not a determinant of an accelerated growth phenotype in ATC.

Graphical Abstract
Dynamic deformation and fault locking of the Xianshuihe Fault Zone, Southeastern Tibetan Plateau: implications for seismic hazards
Authors: Li Layue , Wu Yanqiang , Li Yujiang , Zhan Wei , Liu Xinzhong
Published: February 2022

The Xianshuihe Fault Zone is one of the most historically seismically active regions in mainland China. However, the seismicity along this fault zone has been quiescent for the past 40 years, since the Daofu M6.9 earthquake in 1981. Understanding its current deformation patterns and fault coupling characteristics is of great significance to estimate the potential risk of strong earthquakes. In this study, we analyzed the dynamic deformation and fault coupling characteristics along the Xianshuihe Fault Zone using Global Navigation Satellite System (GNSS) data for 1999–2007 and 2016–2020. The results show that the deformation pattern of the Xianshuihe fault zone underwent a dynamic adjustment after the 2008 Wenchuan Mw7.9 and 2013 Lushan Mw6.6 earthquakes, i.e., the maximum shear strain accumulation rates of the Luhuo and Daofu sections significantly decreased from 6.0 × 10–8/a to 3.2 × 10–8/a, while that of the southeastern segment (i.e., Kangding and Moxi sections) increased from 4.5 × 10–8/a to 6.2 × 10–8/a. Additionally, the slip rate and deformation width of the Xianshuihe Fault Zone also changed during these two periods. Combined with the near-field cross-fault observation data, we suggest that the surrounding strong earthquakes Wenchuan and Lushan had evident differential impacts on the deformation pattern of the Xianshuihe Fault Zone. The fault-coupling inversion results show that the locking degree of the Xianshuihe Fault Zone continued to increase after the Wenchuan and Lushan earthquakes, especially the Qianning and Moxi sections increased significantly, with an average coupling coefficient of greater than 0.9 and left-lateral slip-rate deficits of ~ 5 mm/a and ~ 8 mm/a, respectively. In contrast, the locking degree of the Kangding section decreased with almost no slip-rate deficit, which is in a state of creeping status. The analysis of the recent rupture history and strain accumulation characteristics of the Xianshuihe Fault Zone indicates that both the Qianning and Moxi sections have a high seismic potential for the next strong earthquake in the Xianshuihe Fault Zone.

Graphical Abstract
Cisternal oculomotor schwannoma: a rare cause of anisocoria with ptosis in a child
Authors: Parashar Vasudev , Mathur Vaibhav
Published: February 2022

Background

Primary nerve sheath tumor of cranial nerve is a rare intracranial space occupying lesion that most commonly involves vestibular nerve. Oculomotor nerve schwannoma, without neurofibromatosis, is an extremely uncommon entity especially in children. Though any cranial nerve can be involved by schwannoma except I and II nerve as these cranial nerves lack a Schwann cell sheath.

Case presentation

We herein report a 14-year-old boy presenting with an oculomotor schwannoma in the absence of features of neurofibromatosis, manifesting as progressive diplopia, ptosis, and blurring of vision.

Conclusions

Most similar previous case reports in literature reported oculomotor schwannoma in adults, unlike our case. The detection rate of such rare lesions has, however, increased in the last two decades due to neuroimaging advances.
Glyphosate induces immune dysregulation in honey bees
Authors: Motta Erick V. S. , Powell J. Elijah , Moran Nancy A.
Published: February 2022

Background

Similar to many other animals, the honey beeApis melliferarelies on a beneficial gut microbiota for regulation of immune homeostasis. Honey bees exposed to agrochemicals, such as the herbicide glyphosate or antibiotics, usually exhibit dysbiosis and increased susceptibility to bacterial infection. Considering the relevance of the microbiota–immunity axis for host health, we hypothesized that glyphosate exposure could potentially affect other components of the honey bee physiology, such as the immune system.

Results

In this study, we investigated whether glyphosate, besides affecting the gut microbiota, could compromise two components of honey bee innate immunity: the expression of genes encoding antimicrobial peptides (humoral immunity) and the melanization pathway (cellular immunity). We also compared the effects of glyphosate on the bee immune system with those of tylosin, an antibiotic commonly used in beekeeping. We found that both glyphosate and tylosin decreased the expression of some antimicrobial peptides, such as apidaecin, defensin and hymenoptaecin, in exposed honey bees, but only glyphosate was able to inhibit melanization in the bee hemolymph.

Conclusions

Exposure of honey bees to glyphosate or tylosin can reduce the abundance of beneficial gut bacteria and lead to immune dysregulation.
Enhanced photocatalytic removal of nitric oxide over Ag-decorated ZnSn(OH)6 microcubes
Authors: Pham Minh-Thuan , Van Nguyen Thi , Nguyen Truc Mai Thi , Tran Hong-Huy , Nguyen Hieu Trung , Jiang Jheng-Jie , You Sheng-Jie , Wang Ya-Fen
Published: February 2022

Presently, most of the population has been facing a string of severe air pollution problems that include the intensive emission of nitric oxide (NO), which requires a practical approach to sustain our living conditions. Herein, Ag nanoparticles (Ag NPs)-decorated ZnSn(OH)6 microcubes (Ag:cZHS) photocatalysts are synthesized and used for photocatalytic NO removal under solar light activation. The properties of the newly obtained photocatalysts are comprehensively characterized by a series of typical methods. The NO removal performance over the c:ZHS photocatalysts was increased markedly upon being combined with Ag NPs because of the surface plasmon resonance effect. The contribution of electron (e−), hole (h+), hydroxyl radical (•OH), and oxygen radicals (•O2) was investigated through trapping tests and electron spin resonance analysis. Also, the by-products and apparent quantum efficiency of the photocatalysts were thoroughly studied.
Management of intrathoracic tracheal stenosis: a challenge
Authors: Sathe Nilam U. , Srinivas Anup , Ahmed Saad , Magdum Rajat
Published: February 2022

Background

Tracheal stenosis is a complicated surgical problem, which because of endoscopic techniques can be managed by less invasive procedures. In our case series of three patients with intrathoracic tracheal stenosis following prolonged use of tracheostomy tube, we describe the initial assessment, investigations, management, and post-operative results of the same. In our series, all three patients were tracheostomised (with a metallic tube) for more than 3 months. This resulted in chronic abrasion of intraluminal tracheal mucosa at thoracic level. We managed them with conservative trans-oral and trans-tracheal laser-assisted release instead of open surgeries like trachea-tracheal resection and anastomosis or Crico-tracheal resection and anastomosis.

Results

In our case series, we chose transoral bronchoscopic fibre laser-assisted release followed by dilatation for one patient and trans-tracheal release for the other two. In the trans-oral case, we faced difficulty in controlling the long length of instruments, thereby effecting the control over the laser tip and precision of cut. During the revision surgery for the same patient, we faced difficulty in securing the airway below the stenosis as it was a low stenosis. In patients 2 and 3, we approached the stenosis site via tracheostomy site, thereby significantly reducing the working length of instruments. This gave us better control over the instruments and we attained better precision in radial incisions. Moreover, if there had been an intraoperative bleeding or aspiration, we could have easily secured the airway by FROVA as distance between stoma and stenosis site was not very long.

Conclusion

CO2 Lase-assisted stenosis release has a very promising result in up to grade III thoracic tracheal stenosis. A good preplanning with anaesthetists and cardiothoracic surgeons for tailor made approach is a must. Intermittent apnoea technique of anaesthesia really helps in such cases of intrathoracic tracheal stenosis. We advocate to always use soft material tracheostomy tube to prevent mucosal abrasion, to avoid a low tracheostomy without appropriate and to proper fix the tracheostomy tube and try for early decannulation.
Policy coherence for national climate change adaptation and invasive species management in four countries
Authors: Casey Jonathan Paul
Published: February 2022

This study explores the opportunities for interlinkages across national planning processes for invasive species management (ISM), national climate change adaptation plans (NAPs), national biodiversity management plans (NBSAPs), and other related policies. Focusing on four countries—Pakistan, Zambia, Kenya, and Ghana—the paper aims to identify policy recommendations for more integrated approaches and to achieve greater efficiency in resource allocation and spending. It finds that there is currently very little integration between these policy areas, and little overlap in implementation systems. It identifies sub-national planning and governance systems as an optimal area for increased harmonization of policy and practice to facilitate locally-led climate adaptation and area-specific responses to ISM issues.
Consistency and prior falsification of training data in seismic deep learning: Application to offshore deltaic reservoir characterization
Authors: Pradhan Anshuman , Mukerji Tapan
Published: February 2022

Deep learning (DL) applications of seismic reservoir characterization often require the generation of synthetic data to augment available sparse labeled data. An approach for generating synthetic training data consists of specifying probability distributions modeling prior geologic uncertainty on reservoir properties and forward modeling the seismic data. A prior falsification approach is critical to establish the consistency of the synthetic training data distribution with real seismic data. With the help of a real case study of facies classification with convolutional neural networks (CNNs) from an offshore deltaic reservoir, we have highlighted several practical nuances associated with training DL models on synthetic seismic data. We highlight the issue of overfitting of CNNs to the synthetic training data distribution and propose regularization strategies to address it. We demonstrate the efficacy of our proposed strategies by training the CNN on synthetic data and making robust predictions with real 3D partial stack seismic data.
Forensic psychiatry in the arctic – a comparative study of patient characteristics, health care system and legislation in greenland and nunavut
Authors: Upfold C. , Jentz C. , Chaimowitz G. , Heilmann P. , Nathanielsen N.
Published: February 2022

Introduction

Greenland and the Canadian territory of Nunavut appear to have a different prevalence of forensic psychiatric patients, despite their comparable population and landmass sizes. Both are mainly inhabited by Inuit with a similar cultural and social background. Both have a universal health care system. They differ, however, concerning the supply of mental health services and legislation concerning forensic psychiatric patients.

Objectives

To compare the prevalence and clinical characteristics of forensic psychiatric patients in Greenland and Nunavut.

Methods

Data is obtained from health records, forensic psychiatric evaluations and court acts from all forensic psychiatric patients 18 years or older living in Greenland or admitted to the University Hospital Aarhus (N≈100). Data extracted from Nunavut Review Board hospital reports will be used to describe the patient population from Nunavut (N≈15). Patient characteristics include gender, age, marital status, education, diagnosis of mental illness, medical treatment, family history of mental illness and serious adverse childhood experiences. Public documents concerning health systems and legislation will be identified through literature search.

Results

Patient characteristics from the two patient populations, as well as visualizations of the differences and similarities between the respective health care and legislative systems will be presented at the conference.

Conclusions

This study provides a comprehensive clinical, socio-demographic and forensic comparison of the forensic psychiatric populations in Greenland and Nunavut, Canada. To our knowledge, it will be the first to describe and compare forensic psychiatric populations in the Arctic.
A descriptive study of fratricide in tunisia
Authors: Guermazi A. , Omri S. , Feki R. , Smaoui N. , Bouali M. Maalej , Zouari L. , Thabet J. Ben , Charfi N. , Maalej M.
Published: February 2022

Introduction

Violence between brothers and / or sisters is one of the most important forms of violence within families. To understand homicides between them, the hypothesis of rivalry has been put forward. But how is it really in reality?

Objectives

To construct both the clinical and medicolegal profile of perpetrators of fratricide and sororicide.

Methods

This is a retrospective study of 12 cases of fratricide, which were examined in the context of criminal psychiatric expertise in the psychiatry department of Hedi Chaker University Hospital in Sfax (Tunisia), between January 2002 and December 2018.

Results

The mean age of offenders was 31.9 years; they were all male. Eight fratricide perpetrators were unmarried and had an irregular occupation. They had a psychiatric follow-up prior to homicide in 5 cases. Previous criminal records were noted in one third of the cases. Three perpetrators of fratricide were using psychoactive substances. History of violence against the victim was presented in 7/12 of cases, and the victim was younger than the perpetrator in 5 cases. Aggression was premeditated in 4 cases. The knife was the most used weapon (11/12). Seven offenders suffered from a major mental illness. The most common diagnosis was schizophrenia (6/12). The experts had concluded that 8 cases were in a state of insanity at the time of the offense.

Conclusions

Our data indicates that fratricides are lack preparation and most often preceded by violence. It seems to be important to do other researches to assess psychopathology and assess risk factors for fratricide.
Prevalence and correlates of suicidal behaviour in adolescents with bipolar disorder
Authors: Romero S. , Mendez I. , Lera S. , Santamarina P.
Published: February 2022

Objective

To examine the prevalence and correlates of suicidal behavior among adolescents with bipolar disorder (BD).

Methods

47 adolescents, ages 12 to 19 years (15.8 ± 2), meeting DSM-5 criteria for BD-I (n=40) and BD-II (n=7) were assessed using the KSADS-PL and tested with a battery of tests measuring mood, psychotic symptoms, life events and functioning. History of suicidal attempts (SA) was ascertained using the K-SADS-PL.Results: One third (n=15, 32%) of the BD sample had a lifetime history of SA. There were no differences in socio-demographics factors between SA versus non- SA. BD adolescents with lifetime SA, were more likely to have lower weight at birth, a lifetime history of comorbid eating disorder, non-suicidal self-injurious behavior, 2nd degree family history of suicide attempt, and more stressful life events as compared with non-attempters. Adolescents with lifetime history of SA also showed statistically significant higher scores in depression, suicidal ideation and anxiety as compared with BD adolescents without lifetime SA. Logistic regression analysis found that the most robust correlates of SA in adolescents with BD were having 2nd degree family history of SA, the interaction of self-injury behavior and comorbid eating disorder and increased number of life events. Limitations: Retrospective data. Small sample size. Since this is a cross-sectional study, no inferences regarding causality can be made. Conclusion: One third of the adolescents with BD have attempted suicide. These results are in agreement with previous studies. History of SA in adolescents with BD is strongly associated with family history of suicidal behavior, lifetime self-injury behavior with comorbid eating disorder and increased number of stressful life events.

Disclosure

No significant relationships.
Involuntary placement of a mentally ill person in a psychiatric hospital and care institution
Authors: Arold A. , Kostomarova J.
Published: February 2022

Introduction

In the mental health area, the most problematic issues are the involuntary placement of the mentally ill in closed institutions, both under civil and criminal proceedings, and their involuntary treatment. Despite the international efforts of harmonizing measures, the nature and practice of the services still vary from country to country.

Objectives

To analyse involuntary placement of persons with mental disorders in closed institutions under civil and criminal proceedings, which include both psychiatric hospitals and care institutions.

Methods

Review and analysis of regulations and practice of involuntary placement of a person with a mental disorder in a closed institution in the context of Estonian, Finnish, Russian, and English law, health care and social system.

Results

Estonian, Finnish, Russian, and English law distinguish between criminal and civil proceedings regarding involuntary placement of a mentally ill person in a closed institution. However, specifics of the proceedings are different among the countries, e.g. judicial involvement, and deadlines. Also, the provision of forensic mental health services differ among these countries, e.g. in Estonia offenders and non-offenders are kept separately, whilst in England and Russia patients are not distinguished so strictly.

Conclusions

The distinction between involuntary placement of the mentally ill in criminal and civil proceedings is distinguished primarily for the reason that in one case the risk arising from the person is directly realized by committing an unlawful act and in the other case the risk arising from the person is directed at themselves or is not qualified as an unlawful act.
Policies, recommendations and training to respond to patient microaggressions and hate speech aimed at healthcare professionals: A systematic review
Authors: Wittkower D. , Bryan J. , Asghar-Ali A.
Published: February 2022

Introduction

Patient microaggressions and hate speech affect practitioners in all fields of healthcare. In some facilities, 100% of healthcare workers report experiencing harassment and hate speech, with the aggressors most frequently being patients. To date, there has been no systematic review of policies, recommendations and trainings on patient microaggressions and hate speech against healthcare professionals.

Objectives

A systematic review was conducted to identify recommendations and solutions for healthcare professionals on responding to patient microaggressions and hate speech. Additionally, websites of major healthcare professional organizations and the 6 largest healthcare systems were checked for policy statements related to discrimination by patients towards healthcare providers.

Methods

A literature search of PubMed, PsycINFO, Medline, ERIC and MedEdPORTAL. Articles that contained recommendations and trainings for responding to microaggressions and hate speech were retained. 13 Leading professional organizations and 6 healthcare systems were checked for policies on discrimination by patients.

Results

Our review identified 27 studies providing recommendations and trainings for healthcare professionals to address patient hate speech and microaggressions. Three professional organizations but no healthcare systems had policies on discrimination by patients.

Conclusions

Seven trainings that equip providers with tools to address patient microaggressions and hate speech were identified. Trainings included the ERASE framework; Stop, talk, and roll; interrupting microaggressions; and the OWTFD tool. Nineteen studies outlined recommendations for healthcare professionals and systems on how to respond to patient offenses. Professional organizations and healthcare systems need to create policies to support healthcare professionals who face microaggressions and hate speech.
What is special about suicidal depression?
Authors: Courtet P. , Olie E.
Published: February 2022

Objective

Bipolar disorder is one of the most frequent psychiatric disorders among suicidal patients. A large part of patients with bipolar disorder (30–50%) will attempt suicide. Suicidal ideation being a major risk factor of suicidal act, it is crucial to better characterize patients with suicidal bipolar depression (i.e. depression with current suicidal ideation). The aim of this study was to characterize suicidal bipolar depressed patients in comparison with non-suicidal depressed patients in terms of clinical characteristics, evolution of depression and suicidal ideation course over time, and risk of suicide attempt during follow-up.

Methods

Among patients with bipolar disorder recruited from the network of FondaMental expert centres for bipolar disorder between 2009 and 2017, we selected patients with at least mild depression and without current manic symptomatology at baseline (N = 938). Suicidal depression was defined by a baseline score ⩾2 for item 12 of the QIDS-SR (28.9%). A subsample of about 300 patients (w/ or w/o suicidal ideation at baseline) was followed up for 2 years.

Results

Baseline clinical features (e.g. depression severity, childhood trauma, global functioning) were more severe in patients with without suicidal depression. Suicidal patients tended to remain more suicidal throughout the followup (3.4-fold higher risk of persistent suicidal ideation at the 2-year visit despite an improvement in depressive symptomatology).

Conclusions

Depressed bipolar disorder patients reporting suicidal ideation had more severe clinical features and were more prone to report persistent suicidal ideation during the follow-up, independently of thymic state. Clinicians should closely monitor this subgroup of patients

Disclosure

No significant relationships.
It might not be just an intellectual disability: Change of behavior masking the diagnosis of cancer in a psychiatry unit
Authors: Nombora O.
Published: February 2022

Introduction

Intellectually disabled people are vulnerable to somatic and mental illnesses, often presenting behaviour changes. Moreover, difficulties in describing symptoms can limit their access to healthcare system and adequate treatment.

Objectives

Through a case report, we aim to provide an overview on behaviour changes in people with intellectual disability (ID), emphasizing the screening for organic conditions.

Methods

Description of a clinical case and a qualitative review about the assessment of behaviour changes in persons with ID, using PubMed database.

Results

We present a clinical case of a 57-year-old man with history of ID, alcohol and tobacco abuse and Epilepsy. He had previous acute psychiatric admissions due to behaviour disorganization and irritability. In January he was admitted with disorganized behaviour and caregiver exhaustion, and stabilized with Olanzapine 20mg/day. On the 28th day of hospitalization, he fell of his of bed and suffered a mild traumatic brain injury. Cerebral CT scan revealed two metastatic lesions in the brain. Further investigations found out primary neoplastic lung lesion and multiple metastasis. Afterwards, his relatives mentioned a heavy familiar history of cancer and that he had postural instability signs that they did not value.

Conclusions

Although psychiatric disorders are common in patients with ID, we must always remind that behaviour changes can mask the presentation of an organic disease. Despite a long follow-up in Psychiatry, organic conditions should be considered when patients with ID present behaviour changes. Further studies are needed in the assessment of this particular population to provide proper medical, psychological and social care.
Profile of mood states-27: A valid and reliable measure of negative and positive affect for brazilian pregnant women
Authors: Barros M. , Aguiar M. , Macedo A. , Pereira A.T.
Published: February 2022

Introduction

The original Profile of Mood States (McNair et al. 1971) is composed of 65 items to measure six affect dimensions. There is a Portuguese shorter version (POMS-27) for the perinatal period (Bos et al. 2013), which reduced the number of items (adjectives) down to 27. Although briefer, it still covers relevant mood states with good psychometric properties, being considered a good alternative to use during this demanding and busy period.

Objectives

To test if PoMS-27, composed of four dimensions (Depression, Anxiety, Vigour, Fatigue) and one second-order factor (Negative Affect, composed by the former two) is valid and reliable to be used with pregnant women from Brazil.

Methods

After confirming the items semantic equivalence and slightly adapt two adjectives from European to Brazilian Portuguese, 350 pregnant women (Mean age: 30.01±5.452; Mean gestation weeks=25.17±6.55), with uncomplicated pregnancies, completed the PoMS-27 and the Brazilian recently validated versions of Perinatal Depression Screening Scale and Perinatal Anxiety Screening Scale (PDSS; PASS; Barros et al. 2021). SPSS and AMOS software were used.

Results

After deleting two items (20 and 22) and some errors were correlated, CFA indicated that the PoMS-25 four-dimensional model presented an acceptable fit (χ2=3.163; RMSEA=.079, CFI=.868, TLI=.849). The Cronbach alphas of the dimensions were: Depression (.82), Anxiety (.86), Negative Affect (.89), Fatigue (.80) and Vigor (.50).

Conclusions

Within this psychometric study we found useful, valid and reliable measure of negative and positive affect for Brazilian pregnant women. From now on we will denominate it Profile of Mood States-25Br
History of medical body: Demystifying the continuum of psychiatry and psychoanalysis
Authors: Gairola V.
Published: February 2022

Introduction

The aim of this paper lies in demystifying, historicizing, and de-alienating the relationship between psychiatry and psychoanalysis. Both psychiatry and psychoanalysis inform each other and are informed by each other in various ways which are on one hand similar and on the other hand unique. Medicine can be seen psychoanalytically, and a presenting complaint to a psychoanalytic psychotherapist can be seen in psychiatric terms.

Objectives

This paper theorizes the ‘and’ between psychiatry and psychoanalysis. What is that bridging telling us? There is already an invisible ‘and’ which joins psychiatry and psychoanalysis even before this visible ‘and’ was placed in between them. The effort here is not to undermine the difference. It is to be aware that the thing which separates is also a thing which connects. In other words, each separation is a link. It is to understand how psychiatrists have contributed to the method and practice of psychoanalysis and visa versa. It is about witnessing the continuum that is ever-present between psychiatry, psychology, and psychoanalysis.

Methods

This research used primary sources like books and articles to historicize the psychiatric conceptualization of the medical body.

Results

It shows how psychiatry and psychoanalysis inform each other and are informed by each other. To locate the historical conceptions which are still ever-present in modern psychiatry. How the 18th-century division between normal and abnormal is based on an older division between good and evil.

Conclusions

Good and evil continue to operate in the realm of psychiatry and the confessional becomes a prime source for psychiatry and psychoanalysis.
Risk factors for suicidal behaviours in late-onset bipolar disorder
Authors: Lengvenyte A.
Published: February 2022

Late-onset bipolar disorder (BD), when symptoms emerge after the age of 50 years, has gained recognition in the past decades. Currently, BD of about one in ten older patients is considered to be late-onset. Since suicide risk is extremely elevated in BD, especially at the onset of the illness, patients that live to old age are generally considered a survivor population. Meanwhile, patients with late-onset BD did not have BD while living through life periods that could be associated with typical risk factors for suicidal behaviours. Moreover, the late-onset BD might have specific etiopathogenesis, as demonstrated by less genetic component and more life stressors, medical comorbidity and alcohol use. Clinically, patients with late-onset BD have more depressive episodes and more favourable treatment outcomes, yet clinicians generally fail to adhere to guidelines while treating these patients. In n=614 older age BD patients from FondationFondamental Expert Centers, late-onset BD patients reported less lifetime suicidal ideation and attempts compared to non-late-onset patients, while there was no difference regarding the last year suicidal ideation. Better verbal memory was associated with more suicidal behaviour reporting in both groups. Meanwhile, late-onset patients had lower affect intensity and less childhood trauma – factors that were strongly positively associated with last year suicidal ideation in patients with earlier, but not late-onset BD. Meanwhile, late-onset BD patients had higher arterial blood pressure, which was associated with lifetime suicide attempt history in them, but not in earlier-onset patients. Late-onset BD seems to have a distinct pathway to suicidal behaviours.

Disclosure

No significant relationships.
Measuring therapeutic engagement in finnish adult acute psychiatric in-patient care units using the finnish version of therapeutic engagement questionnaire (TEQ)
Authors: Askola R. , Turunen J. , Hottinen A. , Kantaris X. , Chambers M. , Kuosmanen L.
Published: February 2022

Introduction

The Therapeutic Engagement Questionnaire (TEQ) has been developed and validated in partnership with service users (SUs), registered mental health nurses (RMHNs) and nurse academics in the UK in accordance with psychometric theory. The TEQ is highly relevant and useful to clinical practice. The TEQ measures therapeutic engagement (TE) in two contexts - 1-1 interactions between SUs and RMHNs, as well as the overall environment and atmosphere of the units - from the perspective of both SUs and RMHNs. The TEQ has been translated into Finnish by two expert panels and was pre-tested and validated in ten adult acute psychiatric in-patient units in two hospitals in Finland.

Objectives

To measure TE in Finnish adult acute in-patient psychiatric settings from the perspectives of both SUs and RMHNs.

Methods

The Finnish version of the TEQ (Hoidollinen yhteistyö) will be completed by RMHNs and SUs in 15 adult acute psychiatric in-patient units. Nine of the units are within the University Hospital and six in a municipal psychiatric hospital. The data will be collected within a 3-month period (October - December 2020). The coordinating nurse of each unit will organise the operational side of the study including obtaining consent from SUs. The nurses will participate in the survey via Webropol which includes nurses’ consent. Sociodemographic information will be collected from the SUs and nurses.

Results

The results of the measurement study will be reported at the 29th European Congress of Psychiatry.

Conclusions

The conclusions of the measurement study will be reported at the 29th European Congress of Psychiatry.

Conflict of interest

This study is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London).
The familial experience of acute bacterial meningitis in children. A transversal qualitative study using interpretative phenomenological analysis
Authors: Scanferla E. , Gorwood P. , Fasse L.
Published: February 2022

Introduction

Pediatric acute bacterial meningitis is a life-threatening illness that results from bacterial infection of the meninges and leaves some survivors with significant sequelae. Given the potential trauma induced by the disease itself and the hospitalization, it is important to have an insight on how the parents cope with this aversive event, and especially how they give sense to this experience.

Objectives

(1) To explore the lived experience of close family ascendants whose child or grandchild had survived acute bacterial meningitis (2) To investigate how they give meaning to this specific experience.

Methods

Participants were recruited through two association of persons affected by meningitis. Convenience sample of eleven family ascendants. Their family descendants were aged between 0.2 and 20 years old at the time of the meningitis diagnosis (M= 4.1, SD= 7.3). In average, 9.4 years had passed between the onset of illness and the relative’s interview (SD= 5.4).

Results

6 superordinate themes and 2 meaning-making processes were identified: 1. Sick child becoming a “hero” (comparison with other children). 2. Engaged action/attitude: finding the “positive” of the traumatic experience and engaged action to improve the care system.

Conclusions

This is one of the first studies exploring the first-hand experience of family ascendants confronted to acute bacterial meningitis. Findings highlighted factors characterising the disease experience and the psychological adjustment of meningitis survivors’ families. They demonstred (1) the multidimensional impact of the disease on family ascendants and their need for professional psychological support, (2) the importance of direct involvement of parents in identifying key aspects of care.
Assessing the health-related quality of life of nurses: A study in hedi chacker hospital
Authors: Abbes A. , Kchaou A. , Masmoudi R. , Hrairi A. , Hammami K. Jmal , Masmoudi M. Larbi , Masmoudi J. , Hajjaji M.
Published: February 2022

Introduction

Physical and psychological health, social relationships and professional environment determine the quality of life of nurses.

Objectives

This study aims to evaluate the quality of life of Hospital nurses and to identify the factors that influenced this assessment.

Methods

We conducted a cross-sectional study concerning nurses who answered a questionnaire developed and structured in order to assess the quality of life and with the appliance of the World Health Organization Quality of Life Instrument (WHOQoL-BREF). The statistical processing was done with IBM SPSS Statistics for Windows, Version 21.0.

Results

Most of the nurses were women (78.30%), married (81.70%) and with a specialization degree (65 %). The mean age of the study population was 50.20 years (±7.20 years). Most of them considered their quality of life good or very good (46.7%) and were satisfied or very satisfied with their health (48.4%). There is a significant association between quality of life and satisfaction with life (p=0.000). The average score of Physical health was 55.76(±13.89). The average scale of Psychological health was 61.45 (±15.14). A significant correlation was observed between lack of antecedents and a better physical health (p=0.000).The psychological health was correlated with age (p=0.000) and social relationships (p=0.000).

Conclusions

Studying the quality of life of nurses is particularly important, since it can lead to the development of a policy for improving the working conditions in the public sector.

Conflict of interest

No significant relationships.
Multiple hospitalisations towards the end of life among patients with serious mental illness: A retrospective cohort study in England, UK
Authors: Chukwusa E. , Wilson R. , Gaughran F. , Wei G.
Published: February 2022

Introduction

Multiple hospitalisations towards the end of life is an indicator of poor-quality care. Understanding the characteristics of patients who experience hospitalisations at the end-of-life and how they vary is important for improved care planning.

Objectives

To describe socio-demographic and clinical characteristics of patients diagnosed with serious mental illness who experienced multiple hospitalisations in the last 90 days of life.

Methods

Data for all adult patients with a diagnosis of serious mental illness who died in 2018-2019 in England, UK were extracted from the National Mental Health Services Data Set linked with Hospital Episode Statistics and death registry data. Variables of interest included age, gender, marital status, underlying and contributory cause of death, ethnicity, place of death, deprivation status, urban-rural indicator, and patient’s region of residence. The number of hospitalisations and patient’s sociodemographic & clinical were described using descriptive statistics and percentages, respectively.

Results

Of the 45924 patients, 38.1% (n=17505, Male=42.9%, Female=57.1%, Mean age:78.4) had at least one hospitalisation in the last 90 days of life. The median number of hospitalisations was 2(StdDev:1.64, Minimum=1,Maximum=23). Most of those hospitalised (n=11808, 67.5%), died in a health care establishment (e.g. Hospital or hospice). There were marked geographic differences in the proportions of hospitalisations.The North West region of England recorded the most hospitalisations (n= 2906,16.6%), compared to other regions.

Conclusions

Further analysis is needed to understand factors independently associated with hospitalisations in people with serious mental illness. Funding: This project is supported by the National Institute for Health Research (NIHR) Applied Research Collaborations (ARC) South London.
Work-family-conflict in the context of the working conditions of university employees – comparison of professions
Authors: Jerg-Bretzke L. , Kempf M. , Walter S. , Traue H. , Beschoner P.
Published: February 2022

Introduction

Working conditions at universities are often considered precarious. Employees complain of fixed-term contracts and extensive unpaid overtime (Dorenkamp et al. 2016). Studies from various fields of work show that occupational groups with a high workload suffer particularly from a conflictual compatibility of work and family.

Objectives

The aim of this study was to assess the WFC in the context of working conditions.

Methods

N=844 university employees (55% women, 41% men) were asked about the burden of work/life balance using Work-family-conflict (WFC) - Family-work-conflict (FWC) -Scales (Netemeyer 1996). The dichotomously formulated question on overtime worked was supplemented by a five-step scaled item on the burden of overtime. The correlation analyses were calculated according to Spearman.

Results

Overtime performed by 83% of the total sample and 64% feel burdened by it. 95% of the scientists and physicians, 68% of the administrative staff, 63% of the service providers work overtime and 90% of the physicians and 72% of the scientists feel burdened by it. Significantly high correlations were found between the burden of overtime and the conflict of compatibility. The higher the burden of overtime, the higher the WFC and FWC. The highest correlation was found among physicians (r=.649), followed by scientists (r=.533), administration (r=.451), services (r= (total sample r=.562).

Conclusions

The additional work and strain caused by this, as well as the connections with the problem of compatibility, show need for action for employers regarding the working conditions of physicians and scientists. Especially with regard to reducing overtime and improving the compatibility of work and family.
Psychiatric referrals in general practice
Authors: Turki M. , Babbah T. , Ouali R. , Ellouze S. , Abid W. , Charfi R. , Halouani N. , Alouou J.
Published: February 2022

Introduction

Over half of patients with mental disorders are seen by primary care physicians. However, as for patients with somatic problems, referral to psychiatrists seems to be sometimes necessary.

Objectives

The present study aimed to identify reasons and difficulties perceived by general practitioners (GP) in mental health referrals.

Methods

A cross-sectional web-based survey was conducted between August 22 and September 23, 2020, so that 47 responses of GP were included.

Results

The mean age of respondents was 37.3 years. Their seniority as doctors was 8 years on average. Among them, only 17% attended a post-university psychiatric training. The participants reported that they refer on average 32.5% of patients with mental disorders to psychiatrist: 85.1% to psychiatric hospital, 40.4% to liberal psychiatrists and 21.3% to clinical psychologists. Regarding the reasons for referral to mental healthcare structures, 70.2% of doctors justified their doing so by their insufficient training in mental healthcare; 66% by a need for hospitalization, 57.4% by the presence of delusions, while in 27.7 % of cases, the transfer was carried out at the request of the patient or his family. The difficulties mentioned by GP were patient refusal to consult a psychiatrist (70.2%) and difficulties related to the management delay (44.7%).

Conclusions

Patient and health system factors, as well as physicians experience seem to have important influences on mental health referral. Open communication and ease of consultation with psychiatrists can make the care of patients with mental health problems even more rewarding to the primary care physician.
Combination treatment with second generation antipsychotics other than clozapine
Authors: Schmidt-Kraepelin C.
Published: February 2022

Background

Antipsychotic combination treatment without clozapine is common in the treatment of schizophrenia patients worldwide, despite clinical guidelines generally do not recommend such practice. This is potentially due to a high rate of non-response to monotherapies and a low-frequent adoption of Clozapine.

Aim

This presentation briefly summarizes rational combination strategies without second generation antipsychotics other than clozapine and presents new results of a multi-center randomized, double-blind controlled trial comparing monotherapy of oral amisulpride (400-800 mg/day), or olanzapine (10-20 mg/day) with amisulpride-olanzapine combination treatment.

Conclusions

Positive findings with small to medium effect sizes in favor of combination treatment with amisulpride and olanzapin have to be weight against a higher propensity to side effects since reduced sexual functions, weight gain and gain in waist circumference are higher in patients with combination treatment and olanzapine monotherapy than in patients with amisulpride monotherapy. Overall evidence in favor of combination treatment without clozapine is not strong when regarding its highly-frequent adoption in clinically practice. The strategy of combination treatment with amisulpride and olanzapine may be an alternative in certain clinical situations but should be carefully monitored and justified according to guideline recommendations for resistance to pharmacotherapy.

Comments

The adoption of clozapine should be considered, before other antipsychotic combination treatment is indicated in clinical non-response to various monotherapies. Other factors that may lead to non-response or therapy resistance such as non-adherence, substance-abuse or high metabolization have to be excluded, before such strategy is appropiate.

Disclosure

No significant relationships.