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The study was designed to establish and evaluate the impact of a 6-week Balint group on empathy and resilience in fourth-year medical students during their psychiatry rotation.
This prospective study used the Jefferson Scale of Empathy – Student Version and the Brief Resilience Scale before and after 6-week Balint groups. Participating students also completed a qualitative assessment of their experience.
Students who participated were enthusiastic regarding the value of Balint groups in promoting self-reflection and gaining insight into self- and patient-care dynamics. There was a significant difference in empathy scores pre- and post-Balint intervention. There was no significant difference in resilience scores.
The establishment of a 6-week Balint group for fourth-year medical students was successful in increasing empathy. Students reported a positive view of Balint and its beneficial role in this study group.
The benefit of mandibular advancement devices in patients with sleep-disordered breathing and as a potential option for obstructive sleep apnoea syndrome is well recognised. Their use in the setting of epilepsy or other seizure disorders is typically contraindicated.
A 48-year-old patient with a history of poorly controlled epilepsy and obstructive sleep apnoea syndrome was referred for ENT review for possible tracheostomy. The patient was wheelchair-bound with 24-hour continuous positive airway pressure, but sleep studies demonstrated persistent, severe episodes of apnoea and notable sleep disturbance. Sleep nasendoscopy demonstrated marked improvement on capnography with the laryngeal mask airway in situ, and this was maintained with mandibular advancement using jaw thrust following removal of the laryngeal mask airway. A mandibular advancement device was subsequently trialled; this had no subjective benefit for the patient, but the seizures resolved and control of apnoea was achieved with the combination of a mandibular advancement device and continuous positive airway pressure.
This paper highlights a novel application of mandibular advancement devices, used in combination with continuous positive airway pressure, which resulted in complete resolution of sleep deprivation and apnoea-induced epileptic events.
Conjugated linoleic acid (cis-9, trans-11-C18:2; CLA) in milk arises as a result of microbial biohydrogenation of dietary linoleic and linolenic acids in the rumen (Kepler and Tove, 1967). Milk fat CLA concentrations were significantly (P<0.05) higher when cows were fed silage supplemented with pulp’n brew (a mixture of brewers grains, a by-product of the brewing industry, and sugar beet pulp in dry matter proportions of 0.65:0.35), compared with silage alone (Trial 1). Intake of spring grass resulted in a 2.1–fold increase in milk fat CLA concentrations over cows receiving autumn grass. Throughout lactation in Trial 2, spring calving cows produced higher milk fat CLA concentrations (from 0.5-2.7 g/100 g fatty acid methyl esters (FAME)) than autumn calving cows (0.3-1.7 g/100 g FAME); the former having spent 80% and the latter 50% of lactation on pasture. The CLA content was higher in late lactation milk compared with early lactation milk in both herds. There were no significant differences in milk yields or milk constituent yields between the herds. Manufacturing milk obtained between March and September was analyzed for milk fatty acid composition and the data correlated with grass growth throughout the season. Significant positive correlations were obtained between grass growth rates and concentrations of CLA and linolenic acid in milk fat. The data indicate that seasonal variation in milk fat CLA concentrations may be attributed to variation in pasture growth rates.
We propose an extension of the Distancing-Embracing model to the use of stories for prosocial ends. Specifically, audiences may find stories of individuals in need too emotionally overwhelming. Audiences may attempt to regulate or reduce negative emotions, which can reduce empathy and willingness to help. Through distancing, fictionalized accounts may counteract this tendency and thus increase prosocial behavior.
This study aims to investigate existing evidence for the effectiveness of psychological treatments and/or antidepressant medication as a treatment for those diagnosed with moderate levels of depression.
A PRISMA systematic review of articles using electronic research databases (2000–2014) was conducted to identify studies investigating the effectiveness of psychotherapy and/or medication as a treatment for people with moderate levels of depression. Search terms included moderate depression, psychotherapy and/or medication, depressive disorders, antidepressants, psychotherapy, mental health services, and randomized-controlled trial (RCT). The included studies were then assessed, extracted, and synthesised.
A total of 14 studies met the inclusion criteria (11 RCTs and three additional studies) for this review. The findings of the systematic review indicate that there is limited evidence available specific to the treatment of moderate depression and that this research seems to suggest that psychotherapy or combined treatment has a beneficial effect.
Given that depression is one of the biggest challenges the world faces at present, further research is required to examine the effectiveness of treatment for different levels of depression severity.
Not only is depression associated with increased inflammation but inflammation is a risk factor for the genesis of depression. Many of the environmental risk factors for depression are transduced through inflammatory signaling. Anti-inflammatory agents show promise for the management of depression in preclinical, epidemiological, and early clinical studies. This opens the door to the potential for anti-inflammatory agents to treat and prevent depression. There are no evidence-based pharmacotherapies for depression prevention.
ASPREE-D, aspirin in the prevention of depression in the elderly, is a sub study of ASPREE, which explores the potential of aspirin to prevent a range of inflammation related disorders in the elderly. With a sample size of 19,114, and a duration of 5 years, this placebo controlled study will be one of the largest randomized controlled trials in psychiatry and will provide definitive evidence on the ability of aspirin to prevent depression.
This paper presents the rationale for the study and presents a summary of the study design.
ASPREE-D may not only define novel therapy but will provide mechanistic proof of concept of the role of inflammation in depression.
The basic ideas in this paper are described in recently published papers by Ahern et al. (1977) and Kwok (1977). There are two main points to be made in addition, which remove the differences between these two papers.
Determining which biological traits affect taxonomic durations is critical for explaining macroevolutionary patterns. Two approaches are commonly used to investigate the associations between traits and durations and/or extinction and origination rates: analyses of taxonomic occurrence patterns in the fossil record and comparative phylogenetic analyses, predominantly of extant taxa. By capitalizing upon the empirical record of past extinctions, paleontological data avoid some of the limitations of existing methods for inferring extinction and origination rates from molecular phylogenies. However, most paleontological studies of extinction selectivity have ignored phylogenetic relationships because there is a dearth of phylogenetic hypotheses for diverse non-vertebrate higher taxa in the fossil record. This omission inflates the degrees of freedom in statistical analyses and leaves open the possibility that observed associations are indirect, reflecting shared evolutionary history rather than the direct influence of particular traits on durations. Here we investigate global patterns of extinction selectivity in Devonian terebratulide brachiopods and compare the results of taxonomic vs. phylogenetic approaches. Regression models that assume independence among taxa provide support for a positive association between geographic range size and genus duration but do not indicate an association between body size and genus duration. Brownian motion models of trait evolution identify significant similarities in body size, range size, and duration among closely related terebratulide genera. We use phylogenetic regression to account for shared evolutionary history and find support for a significant positive association between range size and duration among terebratulides that is also phylogenetically structured. The estimated range size–duration relationship is moderately weaker in the phylogenetic analysis due to the down-weighting of closely related genera that were both broadly distributed and long lived; however, this change in slope is not statistically significant. These results provide evidence for the phylogenetic conservatism of organismal and emergent traits, yet also the general phylogenetic independence of the relationship between range size and duration.
Studies of taxonomic diversity over time commonly count and compare first- and last-appearance data (FADs and LADs) over a succession of temporal intervals, and interpret them with respect to taxon origination and extinction. Singleton taxa, which first appear and last appear in the same temporal interval, are often removed from analyses because they might result from preservational biases rather than evolutionary processes, or they might represent non-independent FADs and LADs. Should singleton taxa always be excluded? We argue that in the case of Paleozoic terebratulide brachiopods, although they may be sensitive to biases in sampling intensity, singleton genera should be included in diversity studies because they do not appear to result from more typical biases, such as Lagerstätten and temporal interval length, that arguably can result in artificially high numbers of singleton genera.
Singleton genera can be critical and effective when used to test hypotheses regarding the existence and generation of latitudinal diversity gradients. Contrary to the anti-tropical diversity pattern of modern articulated brachiopods, Paleozoic terebratulides show a latitudinal diversity gradient that peaks in the Tropics. The hypothesis that the Tropics are either a diversity source or sink can be tested by comparing FAD and LAD latitudes. For singleton genera, FAD and LAD latitudes are taken from the same data points and must be removed for statistical comparisons to be valid. We suggest that taxon age distributions can accommodate singleton data, as the taxon age metric considers origination and extinction simultaneously. We generated taxon age distributions to test the hypothesis that the observed Paleozoic diversity gradient results from a latitudinal bias in generic turnover rate. We discovered that singletons are not randomly distributed over latitude, with proportionally more singleton genera occurring in the Tropics. In this case, singleton genera may reflect rapid evolutionary turnover of taxa, rather than simply preservational bias. Methods that can accommodate singleton taxa should be used to study the diversity of Paleozoic terebratulides and possibly other well-skeletonized marine metazoans.
We describe two cases of infant botulism due to Clostridium butyricum producing botulinum type E neurotoxin (BoNT/E) and a previously unreported environmental source. The infants presented at age 11 days with poor feeding and lethargy, hypotonia, dilated pupils and absent reflexes. Faecal samples were positive for C. butyricum BoNT/E. The infants recovered after treatment including botulism immune globulin intravenous (BIG-IV). C. butyricum BoNT/E was isolated from water from tanks housing pet ‘yellow-bellied’ terrapins (Trachemys scripta scripta): in case A the terrapins were in the infant's home; in case B a relative fed the terrapin prior to holding and feeding the infant when both visited another relative. C. butyricum isolates from the infants and the respective terrapin tank waters were indistinguishable by molecular typing. Review of a case of C. butyricum BoNT/E botulism in the UK found that there was a pet terrapin where the infant was living. It is concluded that the C. butyricum-producing BoNT type E in these cases of infant botulism most likely originated from pet terrapins. These findings reinforce public health advice that reptiles, including terrapins, are not suitable pets for children aged <5 years, and highlight the importance of hand washing after handling these pets.
Bilateral flows of international migrants exhibit tremendous variance both across destination countries and over time. To explain this variance, studies of international migration tend to focus on economic determinants such as income differentials or on social conditions such as the presence of coethnics in certain destination countries. The authors argue that migration is driven not solely by economic or social determinants; rather, the political environment across destinations plays a substantively large role in influencing bilateral migration flows. They test the importance of the political environment—citizenship rights and the prominence of right-wing parties—using data on migration flows from 178 origin countries into 18 destination countries over the period 1980–2006. They find, even after controlling for a variety of economic, social, policy, and international variables, that variation in political environments across time and destination plays a key role in observed patterns of international migration.
Rates of self-harm are high and have recently increased. This trend and the repetitive nature of self-harm pose a significant challenge to mental health services.
To determine the efficacy of a structured group problem-solving skills training (PST) programme as an intervention approach for self-harm in addition to treatment as usual (TAU) as offered by mental health services.
A total of 433 participants (aged 18–64 years) were randomly assigned to TAU plus PST or TAU alone. Assessments were carried out at baseline and at 6-week and 6-month follow-up and repeated hospital-treated self-harm was ascertained at 12-month follow-up.
The treatment groups did not differ in rates of repeated self-harm at 6-week, 6-month and 12-month follow-up. Both treatment groups showed significant improvements in psychological and social functioning at follow-up. Only one measure (needing and receiving practical help from those closest to them) showed a positive treatment effect at 6-week (P = 0.004) and 6-month (P = 0.01) follow-up. Repetition was not associated with waiting time in the PST group.
This brief intervention for self-harm is no more effective than treatment as usual. Further work is required to establish whether a modified, more intensive programme delivered sooner after the index episode would be effective.
Feet and legs issues are some of the main causes for sow removal in the US swine industry. More timely lameness detection among breeding herd females will allow better treatment decisions and outcomes. Producers will be able to treat lame females before the problem becomes too severe and cull females while they still have salvage value. The objective of this study was to compare the predictive abilities and accuracies of weight distribution and gait measures relative to each other and to a visual lameness detection method when detecting induced lameness among multiparous sows. Developing an objective lameness diagnosis algorithm will benefit animals, producers and scientists in timely and effective identification of lame individuals as well as aid producers in their efforts to decrease herd lameness by selecting animals that are less prone to become lame. In the early stages of lameness, weight distribution and gait are impacted. Lameness was chemically induced for a short time period in 24 multiparous sows and their weight distribution and walking gait were measured in the days following lameness induction. A linear mixed model was used to determine differences between measurements collected from day to day. Using a classification tree analysis, it was determined that the mean weight being placed on each leg was the most predictive measurement when determining whether the leg was sound or lame. The classification tree’s predictive ability decreased as the number of days post-lameness induction increased. The weight distribution measurements had a greater predictive ability compared with the gait measurements. The error rates associated with the weight distribution trees were 29.2% and 31.3% at 6 days post-lameness induction for front and rear injected feet, respectively. For the gait classification trees, the error rates were 60.9% and 29.8% at 6 days post-lameness induction for front and rear injected feet, respectively. More timely lameness detection can improve sow lifetime productivity as well as animal welfare.