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The aim of the project was to get a baseline of the number of patients who have had blood tests, ECG and physical health observations completed in the past 12 months.
There are 30 patients under Early Intervention in Psychosis team at Bassetlaw Hospital , Nottinghamshire. The elctronic notes and blood reporting system were checked for each of the patients, to get the data on blood test results , ECG reports and Physical health (Blood pressure, heart rate and weight) .
It was noted that 19/30 patients had Blood tests completed, 14/30 had ECG completed and 19/30 had physical health checks completed. All these patients except one were on antipsychotic medications.
Further work is still required in getting 100% results for all these different variables. This may include the need to review the process of how we engage the patients for physical healthcare checks. With the inclusion of a physical healthcare worker now, we might be able to improve results. Hence this evaluation would be redone in a years' time.
We report two cases of respiratory toxigenic Corynebacterium diphtheriae infection in fully vaccinated UK born adults following travel to Tunisia in October 2019. Both patients were successfully treated with antibiotics and neither received diphtheria antitoxin. Contact tracing was performed following a risk assessment but no additional cases were identified. This report highlights the importance of maintaining a high index of suspicion for re-emerging infections in patients with a history of travel to high-risk areas outside Europe.
In times of labour market insecurity and retrenchment of state support, low income families rely on friends and relatives as a safety net. This article explores the enhanced role of this ‘third source of welfare’ in light of these developments. It draws on qualitative longitudinal research to demonstrate how families’ situations fluctuate over two years and the importance of social support networks in hard times and periods of crisis. The research illustrates how social support is not necessarily a stable structure that families facing insecurity can fall back on, but rather a variable resource, and fluid over time, as those who provide such support experience changing capabilities and needs. A policy challenge is to help reinforce and not undermine the conditions that enable valuable social support to be offered and sustained, while ensuring sufficient reliable state support to avoid families having no choice but to depend on this potentially fragile resource as a safety net.
The United States’ criminal justice system has seen exponential growth in costs related to the incarceration of persons with mental illness. Jails, prisons, and state hospitals’ resources are insufficient to adequately treat the sheer number of individuals cycling through their system. Reversing the cycle of criminalization of mental illness is a complicated process, but mental health diversion programs across the nation are uniquely positioned to do just that. Not only are these programs providing humane treatment to individuals within the community and breaking the cycle of recidivism, the potential fiscal savings are over 1 billion dollars.
Distress intolerance has been suggested to be a maintaining factor in several mental health conditions. Distress tolerance skills training has been found to be beneficial in emotionally unstable personality disorder (EUPD) and post-traumatic stress disorder (PTSD). Short-term targeted interventions are increasingly being implemented in response to demand. This study investigates the efficacy of a distress tolerance brief psychological intervention (DT BPI) delivered by non-psychologists within an adult secondary care mental health service. Questionnaire data (pre and post) are reported from 43 participants who completed the intervention. Results suggest that the intervention was associated with significant improvements in distress tolerance, mood, anxiety and wellbeing. This indicates that a DT BPI can be effective when delivered by non-psychologists to real-world adult secondary care clients. The findings offer promising evidence that DT BPI could be a beneficial, cost-effective intervention and warrants further large-scale investigation.
Key learning aims
(1) To enhance practitioners’ awareness of distress intolerance as a potential maintaining factor and therefore treatment target.
(2) To outline a transdiagnostic distress tolerance brief psychological intervention.
(3) To illustrate the potential of this distress tolerance brief psychological intervention to produce positive reliable change with real-world clients when delivered by non-psychologists.
This study identified underlying career orientation types of clinical research coordinators (CRCs) using cluster analysis. Select career (satisfaction, engagement, and planning) and competency-related (perceived competence) information was used to identify four distinct career orientation types.
A web-based survey was administered to CRCs employed in one of four research institutions affiliated with a National Institutes of Health-funded Clinical and Translational Research Award (CTSA) in the southeastern USA. Each respondent completed a survey containing questions about personal background, individual attributes, perceived professional competence, and career orientation.
The first CRC type (35.2%) possessed a positive, knowledge-seeking orientation, characterized by high career-related scores but a conservative assessment of perceived competence. The second CRC type (18.6%) represented an optimistic and confident career orientation reflected in moderate to high scores on each of the four identifying factors. The third CRC type (27.6%) reflected an inconsistent career orientation highlighted by lowered perceived competence. The final CRC type (18.6%) reflected a disengaged orientation characterized by negative responses to all career and competence factors.
Understanding the career orientation of CRCs can be helpful to institutional administrators and clinical investigators as they seek to support the professional development of CRCs through tailored training efforts or work-related supports. Knowledge of career orientation may also inform individual CRCs as they manage their personal career paths by assessing current levels of functioning, career-related strengths or weaknesses, and training needs.
Rapid diagnostic technologies can assist Antimicrobial Stewardship Programs (ASPs) in achieving the goals of reducing unnecessary antimicrobial exposure and optimizing patient care. The Society of Infectious Diseases Pharmacists supports all members of the ASP team as essential components of optimal use of these technologies for management of antibiotic prescribing and cost-reduction strategies.
National organisations in several countries have recently released more restrictive guidelines for infective endocarditis prophylaxis, including the American Heart Association 2007 guidelines. Initial studies demonstrated no change in infective endocarditis rates over time; however, a recent United Kingdom study suggested an increase; current paediatric trends are unknown.
Children (<18 years) hospitalised with infective endocarditis at 29 centres participating in the Pediatric Health Information Systems Database from 2003 to 2014 were eligible for inclusion. Our primary analysis focussed on infective endocarditis most directly related to the change in guidelines and included community-acquired cases in those >5 years of age. Interrupted time series analysis was used to evaluate rates over time indexed to total hospitalisations.
A total of 841 cases were identified. The median age was 13 years (interquartile range 9–15 years). In the pre-guideline period, there was a slight increase in the rate of infective endocarditis by 0.13 cases/10,000 hospitalisations per semi-annual period. In the post-guideline period, the rate of infective endocarditis increased by 0.12 cases/10,000 hospitalisations per semi-annual period. There was no significant difference in the rate of change in the pre- versus post-guidelines period (p=0.895). Secondary analyses in children >5 years of age with CHD and in children hospitalised with any type of infective endocarditis at any age revealed similar results.
We found no significant change in infective endocarditis hospitalisation rates associated with revised prophylaxis guidelines over 11 years across 29 United States children’s hospitals.
What is the status of women's writing in German today, in an era when feminism has thoroughly problematized binary conceptions of sex and gender? Drawing on gender and queer theory, including the work of Lauren Berlant, Judith Butler, and Michel Foucault, the essays in this volume rethink conventional ways of conceptualizing female authorship and re-examine the formal, aesthetic, and thematic terms in which "women's literature" has been conceived. With an eye to the literary and feminist legacy of authors such as Christa Wolf and Ingeborg Bachmann, contributors treat the works of many of contemporary Germany's most significant literary voices, including Hatice Akyün, Sibylle Berg, Thea Dorn, Tanja Dückers, Karen Duve, Jenny Erpenbeck, Julia Franck, Katharina Hacker, Charlotte Roche, Julia Schoch, and Antje Rávic Strubel -- authors who, through their writing or their role in the media, engage with questions of what it means to be a woman writer in twenty-first-century Germany. Contributors: Hester Baer, Necia Chronister, Helga Druxes, Valerie Heffernan, Alexandra Merley Hill, Lindsey Lawton, Sheridan Marshall, Beret Norman, Mihaela Petrescu, Jill Suzanne Smith, Carrie Smith-Prei, Maria Stehle, Katherine Stone. Hester Baer is Associate Professor of Germanic Studies at the University of Maryland. Alexandra Merley Hill is Assistant Professor of German at the University of Portland.
The development of native language phonetic representations in bilingual infants was compared to that of monolingual infants. Infants (ages 6–8, 10–12, and 14–20 months) from English–French or English-only environments were tested on their ability to discriminate a French and an English voice onset time distinction. Although 6- to 8-month-olds responded similarly irrespective of language environment, by 10–12 months both groups of infants displayed language-specific perceptual abilities: the monolinguals demonstrated realignment to the native English boundary whereas the bilinguals began discriminating both native boundaries. This suggests that infants exposed to two languages from birth are equipped to phonetically process each as a native language and the development of phonetic representation is neither delayed nor compromised by additional languages.
Substance use is implicated in the cause and course of psychosis.
To characterise substance and alcohol use in an epidemiologically representative treatment sample of people experiencing a first psychotic episode in south Cambridgeshire.
Current and lifetime substance use was recorded for 123 consecutive referrals to a specialist early intervention service. Substance use was compared with general population prevalence estimates from the British Crime Survey.
Substance use among people with first-episode psychosis was twice that of the general population and was more common in men than women. Cannabis abuse was reported in 51% of patients (n=62) and alcohol abuse in 43% (n=53). More than half (n=68, 55%) had used Class A drugs, and 38% (n=43) reported polysubstance abuse. Age at first use of cannabis, cocaine, ecstasy and amphetamine was significantly associated with age at first psychotic symptom.
Substance misuse is present in the majority of people with first-episode psychosis and has major implications for management. The association between age at first substance use and first psychotic symptoms has public health implications.