281 research outputs found

    The pneumatisation of anterior clinoid process is not associated with any predictors that might be recognised preoperatively

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    The anterior clinoid process (ACP) is usually removed during surgeries of proximalinternal carotid artery (ICA) aneurysms. However, some ACPs presentwith air cells originating from the sphenoid or/and ethmoid sinus. In surgeriescontaining a clinoidectomy of a pneumatised process, up to 40% of patients experience cerebrospinal fluid (CSF) rhinorrhoea. The aim of this study wasto explore the potential predictors of pneumatisation of the ACP, as well asto compare the occurrence of CSF rhinorrhoea between total and partialanterior clinoidectomies. This study comprised 2 different groups, with 2 differentanalyses. Firstly, the pneumatisation of the ACP was evaluated in 496 ACPs and was based on 248 computer tomography exams (CT). The c2 testand ROC curve comparisons were utilised in conjunction, to explore possiblepredictors of air cell accumulation in the ACP. The overall pneumatisation ratewas 9.7%, unilateral and bilateral aerial ACP was found in 4.4% and 2.6% of all patients respectively, while at least one pneumatised ACP was found in 14.1% of examined patients. The route of pneumatisation was establishedin 87.5% of cases. The side of the ACP, gender, and patient age were notsignificantly associated with both pneumatisation of ACP or route of pneumatisation.Secondly, a clinical group of 23 patients after operative securingof an ICA aneurysm were retrospectively assessed with regards to the extentof anterior clinoidectomy and the occurrence of CSF rhinorrhoea. A total of23 ACPs were removed, 17 ACPs were totally resected, and 6 underwent partialresection. CSF rhinorrhoea was not noted in any patients, thus the comparison between clinical groups was not valid. Moreover, we described a novelmethod of partial removal of the lateral aspect of ACP, which was applied in6 patients treated for an ICA — ophthalmic artery junction aneurysm

    Culturally Adapted Interventions in Mental Health: Global Position Statement

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    The preponderance of western psychological concepts are often relied upon to conceptualise health-related phenomena. It is hardly surprising therefore that despite the availability of a number of interventions, studies have concluded that outcomes for minority cultural groups are not as good as for Caucasian people (western Europe and North America) in many high and middle income countries (HMIC). The evidence base of most psychosocial interventions is yet to be established in Low and Middle Income Countries (LMICs). There has been a propensity in some quarters to view low and middle income countries as passive beneficiaries of mental health knowledge, rather than as contributors or partners in knowledge production and development. A move towards a more equal bilateral relationship is called for, which should lead to better service provision. This Position Statement aims to highlight the current position and need for culturally adapted interventions. It is a global call for action to achieve a standardised mechanism to achieve parity of access and outcomes across all cultural groups regardless of country of residence

    Examining methods, messengers and behavioural theories to disseminate physical activity information to individuals with a diagnosis of schizophrenia: a scoping review

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    Background: Many individuals with a diagnosis of schizophrenia are not active and lack the necessary knowledge and confidence to become and stay active. To develop effective physical activity promotion interventions, it is necessary to identify credible messengers and effective methods to disseminate physical activity information to this population. Aims: The purpose of this scoping review was to identify and examine knowledge mobilization theories, messengers and methods used to disseminate physical activity information to individuals with a diagnosis of schizophrenia. Method: This scoping review followed the methodological framework proposed by Arksey and O'Malley. Results: In total, 43 studies and 7 reviews identified multiple messengers and methods used to disseminate physical activity information to individuals with a diagnosis of schizophrenia, but few attempts to structure information theoretically. Findings do not point to which messengers or methods are most effective or which theories should be used to construct information interventions. Studies show that physical activity information should be provided in an individualised manner from staff who could easily connect with patients. Conclusions: Few researchers have addressed the physical activity information needs of individuals with a diagnosis of schizophrenia. Researchers need to examine and implement effective knowledge mobilization strategies for this population

    Reduced expression of monocyte CD200R is associated with enhanced proinflammatory cytokine production in sarcoidosis

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    In sarcoidosis, the proinflammatory cytokines interferon gamma, tumour necrosis factor and interleukin-6 are released by monocyte-derived macrophages and lymphocytes in the lungs and other affected tissues. Regulatory receptors expressed on monocytes and macrophages act to suppress cytokine production, and reduced expression of regulatory receptors may thus promote tissue inflammation. The aim of this study was to characterise the role of regulatory receptors on blood monocytes in patients with sarcoidosis. Cytokine release in response to stimulation of whole blood was measured in healthy controls and Caucasian non-smoking patients with sarcoidosis who were not taking disease modifying therapy. Expression of the regulatory molecules IL-10R, SIRP-α/β, CD47, CD200R, and CD200L was measured by flow cytometry, and functional activity was assessed using blocking antibodies. Stimulated whole blood and monocytes from patients with sarcoidosis produced more TNF and IL-6 compared with healthy controls. 52.9% of sarcoidosis patients had monocytes characterised by low expression of CD200R, compared with 11.7% of controls (p < 0.0001). Patients with low monocyte CD200R expression produced higher levels of proinflammatory cytokines. In functional studies, blocking the CD200 axis increased production of TNF and IL-6. Reduced expression of CD200R on monocytes may be a mechanism contributing to monocyte and macrophage hyper-activation in sarcoidosis

    Device-based 24-hour movement behaviours in adult phase III cardiac rehabilitation service-users during the COVID-19 pandemic: a mixed-methods prospective observational study

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    Purpose To examine changes in device-based 24-hour movement behaviours (MB), and facilitators and barriers to physical activity (PA) and exercise, during remotely-delivered cardiac rehabilitation (RDCR). Materials and methods This prospective observational study used wrist-worn GENEActiv accelerometers to assess MB of 10 service-users (63 ± 10 years) at the start, middle, and end of three-months of RDCR. Barriers and facilitators to PA and exercise were explored through self-report diaries and analysed using content analysis. Results At start, service-users were sedentary for 12.6 ± 0.7 h ⋅ day−1 and accumulated most PA at a light-intensity (133.52 ± 28.57 min ⋅ day−1) – neither changed significantly during RDCR. Sleep efficiency significantly reduced from start (88.80 ± 4.2%) to the end (86.1 ± 4.76%) of CR, with values meeting health-based recommendations (≥85%). Barriers to RDCR exercise included exertional discomfort and cardiac symptoms, and reduced confidence when exercising alone. Setting meaningful PA goals, self-monitoring health targets, and having social support, facilitated PA and exercise during RDCR. Conclusions Our RDCR programme failed to elicit significant changes in MB or sleep. To increase the likelihood of successful RDCR, it is important to promote a variety of exercise and PA options, target sedentary time, and apply theory to RDCR design, delivery, and support strategies. IMPLICATIONS FOR REHABILITATION Practitioners should work with service-users to understand how best to support them to maximise the benefit(s) of remotely/hybrid delivered services. Facilitating easy (and regular) access to health professionals during remotely/hybrid delivered cardiac rehabilitation (CR) will support the development of service-users’ physical activity (PA) and exercise self-efficacy (i.e., confidence). Remotely/hybrid delivered CR should be informed by theory and/or behaviour change techniques to support increased PA, reduced sedentary time and improved sleep during and after CR. It is important to include strategies to reduce sedentary time in addition to targeting PA and exercise in remotely-delivered CR
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