The Demonization of Sidney’s Cecropia: Erasing a Legal Identity

In October fo 1533, fourteen-year-old Catherine de\u27 Medici married Henri, duc d\u27Orléans in a union meant to secure a favorable political alliance between Francis I, the King of France and Pope Clement VII, her uncle and legal guardian. When, however, the Pope unexpectedly died less than a year later, Catherine’s symbolic worth virtually died as well: leaving a less than enamored France to bear the burden of one whose status, as R. J. Knecht has noted, “was immediately reduced to that of a foreigner of relatively modest origins.”1 When Henri unexpectedly died following a ceremonial jousting match in 1559, Catherine became positively reviled. By the time she died in 1589, she had been thoroughly vilified by virtually all of sixteenth-century Europe. Not only was she blamed for masterminding the massacre of thousands of Huguenots at Paris in 1572, but she was held at least partially accountable for the political unrest regarding the marriage question which unsettled England during much of Elizabeth’s reign

A CNS-led intervention to improve rates of respiratory mechanical device-related pressure injuries in critically ill patients : a DNP project

Background: There is a new focus on medical device-related pressure injuries (MDRPI). Endotracheal tubes (ETT) and their fasteners constitute a portion of these injuries and may lessen the quality of life and function of the critically ill patients who suffer from them. Local Problem The purpose of this quality improvement project was to determine if a bundle of interventions in patients with ETT and their fasteners may lessen the rate of mechanical device-related pressure injuries. Methods/Interventions: The project consisted of pre-and post-intervention surveys of nursing comfort with ETT movement/assessments, implementation of a standardized turn clock to have all ETTs in the same location and moved every 2-3 hours, and job aids related to the assessment and documentation of ETT movement. Results: The project's pre-implementation survey revealed that some nurses were uncomfortable with manipulating the ETT tube and may prevent them from moving the ETT. The post-implementation survey demonstrated improved comfort with moving the ETT. While nurses felt they regularly assessments, they acknowledge that do not often chart ETT movement. Documentation audits bore out these claims \u2070\u301\u2083 most charts did not include ETT movement or peri\u2070\u301\u2083oral/mucosal tissue assessments. Of note, in the three months before the project, there were 3 ETT-related pressure injuries, and none during the implementation. Conclusions: This project sought to determine whether a bundle of interventions might lessen the rate of MDRPI associated with ETT and their fasteners. This bundle of interventions may be useful to other healthcare organizations struggling with this subset of pressure injury.Thesis (D.N.P.)--Michigan State University. Clinical nurse specialist, 2024Includes bibliographical references (pages 28-33

Sleep quality and its clinical associations in trichotillomania and skin picking disorder.

BACKGROUND: Trichotillomania (TTM) is characterized by recurrent hair pulling and associated hair loss. Skin picking disorder (SPD) is characterized by recurrent skin picking and associated scarring or tissue damage. Both disorders are also accompanied by psychological distress and poor sleep. Very little, however, is known about lifestyle variables that may contribute to symptom severity in these disorders. METHODS: We recruited 87 adults as part of a cross-sectional study of 3 groups (TTM, SPD, and non-affected). Clinical subjects (n=69) were compared with controls (n=18) on sleep quality as measured by Pittsburgh Sleep Quality Index (PSQI). We used partial least squares regression to identify which variables were significantly associated with poor sleep quality among those participants with TTM or SPD. RESULTS: Clinical subjects had significantly poorer sleep quality than controls. Sleep quality was significantly related to older age, worse perceived stress, lower distress tolerance and greater impulsivity in adults with BFRBs. Poor sleep quality was associated with worse hair pulling symptom severity but not skin picking severity. Higher levels of comorbid mental disorders was also associated with worse sleep, above and beyond the impact of these other variables. CONCLSUIONS: Poor sleep quality appears to be related to multiple variables. Further research is needed to determine causality and to tailor treatment to specific patient needs

Sleep quality and its clinical associations in trichotillomania and skin picking disorder.

BACKGROUND: Trichotillomania (TTM) is characterized by recurrent hair pulling and associated hair loss. Skin picking disorder (SPD) is characterized by recurrent skin picking and associated scarring or tissue damage. Both disorders are also accompanied by psychological distress and poor sleep. Very little, however, is known about lifestyle variables that may contribute to symptom severity in these disorders. METHODS: We recruited 87 adults as part of a cross-sectional study of 3 groups (TTM, SPD, and non-affected). Clinical subjects (n=69) were compared with controls (n=18) on sleep quality as measured by Pittsburgh Sleep Quality Index (PSQI). We used partial least squares regression to identify which variables were significantly associated with poor sleep quality among those participants with TTM or SPD. RESULTS: Clinical subjects had significantly poorer sleep quality than controls. Sleep quality was significantly related to older age, worse perceived stress, lower distress tolerance and greater impulsivity in adults with BFRBs. Poor sleep quality was associated with worse hair pulling symptom severity but not skin picking severity. Higher levels of comorbid mental disorders was also associated with worse sleep, above and beyond the impact of these other variables. CONCLSUIONS: Poor sleep quality appears to be related to multiple variables. Further research is needed to determine causality and to tailor treatment to specific patient needs

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Exploring the Usefulness of Pre-Visit Materials for Children with Autism at a Public Museum

Abstract Children with autism spectrum disorder (ASD) participate in community-based settings at lower rates than typically developing children. Museums provide a structured, predictable, and supportive place for children with ASD to learn. Visiting a museum may create unique challenges for children with ASD and their families. Sensory processing disorder (SPD) is a common barrier to participation that makes it difficult to process information coming in through the senses. For children who are easily overstimulated, crowds, noise, and long lines can be a source of anxiety and stress. Providing pre-visit materials such as social stories, accessibility maps, and communication books can support engagement in the museum setting. This study explored the usefulness of pre-visit materials for children with ASD who attended a low sensory event at a public museum. Data were collected during interviews with 22 parents and care partners. All participants found the pre-visit materials useful before and during the museum visit. Participants provided recommendations for improvement including developing multiple formats (e.g., audio, video), different languages, and limiting the pictures per page. This study highlights the unique value of occupational therapy in a community setting. Occupational therapists consider how features of the environment may support or limit participation. The pre-visit materials developed in this study may help museums offer more inclusive experiences to children with ASD and their families. Partnerships with disciplines such as occupational therapy may help museums and other community organizations welcome visitors of all abilities. Plain Language Summary Museums are key educational resources in the community. Families of children with autism spectrum disorder (ASD) face unique challenges to participating in museum settings. This study explored the usefulness of pre-visit materials including a social story, accessibility map, and communication book. These materials were developed through a partnership between a public museum, occupational therapy graduate program, and 22 parents and care partners of children with ASD. All participants found the pre-visit materials useful for improving participation in a museum visit. This study highlights the unique value of occupational therapy at a museum. The materials developed for this study could be replicated to promote a more inclusive experience in other community settings. Partnering with disciplines experienced in working with people with disabilities can assist in creating welcoming environments for people of all abilities. Additional research is needed to explore the benefits of collaborative partnerships between community organizations and occupational therapy programs

A computational signature of self-other mergence in Borderline Personality Disorder

A tendency to merge mental representations of self and other is thought to underpin the intense and unstable relationships that feature in Borderline Personality Disorder (BPD). However, clinical theories of BPD do not specify, in computational terms, how the perspectives of self and other might become confused. To address this question, we used a probabilistic false belief task (p-FBT) to examine how individuals with BPD (N = 38) and matched controls from the general population (N = 74) selectively assigned beliefs to self or other. The p-FBT requires participants to track a gradually changing quantity, whilst also predicting another person’s belief about that quantity. We found that BPD participants showed less selectivity in belief assignment compared with controls (Cohen’s d = 0.64). Behaviourally, participants with BPD tended to predict that others’ beliefs resembled their own. Modelling analysis revealed that BPD participants were prone to generalise their own learning signals to others. Furthermore, this generalising tendency correlated with BPD symptomatology across participants, even when controlling for demographic factors and affective psychopathology. Our results support a computational account of self-other mergence, based on a generalisation of learning across agents. Self-other generalisation in learning purports to explain key clinical features of BPD, and suggests a potential transdiagnostic marker of mentalising capability

Adapting services for autism: Recommendations from a specialist multidisciplinary perspective using freelisting

The guidance available for tailoring mental health services for autistic people is limited and dispersed. Practitioners attempting to appropriately adapt mental healthcare and therapy provision report low confidence and inconsistency in their approach. This study contributes to the guidance by providing a shortlist of usable and priority adaptations for diagnostic and therapy services as described by multidisciplinary staff members responsible for the design and delivery of a specialist autism service in the UK. Individual freelisting interviews were conducted with 15 staff, who were asked to list the ways that they adapt their practice individually, within therapy, and collectively as a service. Salience and cultural consensus analyses demonstrated the following agreed priority service adaptations: ensuring the suitability of the service environment with consideration of sensory demands, adapting communication, knowing individual gender identity preferences and minimising client uncertainty. Detailed examples are given for flexibly adapting therapy to individual needs to inform general and specialist services. The findings require replication and evaluation

MR-guided beam gating: Residual motion, gating efficiency and dose reconstruction for stereotactic treatments of the liver and lung

PURPOSE This study aims to investigate the efficiency and the geometric as well as the dosimetric benefit of magnetic-resonance guided beam gating for stereotactic treatments in moving organs. METHOD Patients treated with MR-guided (MRIdian system) SBRT for lung (n = 10) and liver (n = 10) targets were analyzed. Breath-hold gating was performed based on lesion tracking in sagittal cine MRI images. The target offset from the geometric center of the gating window with and without gating was evaluated. A dose reconstruction workflow based on convolution of these 2D position-probability maps and the daily 3D dose distribution was used to estimate the daily delivered dose including motion. The dose to the clinical target volume (CTV) and to a 2-cm ring structure around the planning target volume were evaluated. RESULTS The applied gating protocol resulted in a mean (±standard deviation) gating efficiency of 55%±16%. Over all patients, the mean target offset (2D-root-mean-square error) was 8.3 ± 4.3 mm, which reduced to 2.4 ± 0.6 mm during gating. The dose reconstruction showed a mean deviation in CTV coverage (D95) from the static plans of -1.7%±1.8% with gating and -12.0%±8.4% if no gating would have been used. The mean dose (Dmean) in the ring structure, with respect to the static plans, showed mean deviations of -0.1%±0.3% with gating and -1.6%±1.8% without gating. CONCLUSION The MRIdian system enables gating based on the inner anatomy and the implemented dose reconstruction workflow demonstrated geometric robust delivery of the planned radiation doses