612 research outputs found
Adapting group schema therapy for older adults with personality disorders:Lessons learnt
A first empirical study into group schema therapy in older adults with mood disorders and personality disorder (PD) features has shown that brief group schema therapy has potential to decrease psychological distress and to change early maladaptive schemas (EMS). Effect sizes however were smaller than those found in similar studies in younger adults. Therefore, we set out to adapt the treatment protocol for older adults in order to enhance its feasibility and outcome in this age group. We examined this adapted protocol in 29 older adults (mean age 66 years) with PDs from four Dutch mental health institutes. The primary outcome was symptomatic distress, measured by the Brief Symptom Inventory. Secondary outcomes were measured by the Young Schema Questionnaire, the Schema Mode Inventory, and the short version of the Severity Indices of Personality Problems. Contrary to our expectations, the adapted treatment protocol yielded only a small effect size in our primary outcome, and no significant improvement in EMS, modes and personality functioning. Patients pointed out that they were more aware of their dysfunctional patterns, but maybe they had not been able yet to work on behavioural change due to this schema therapy treatment being too brief. We recommend more intensive treatment for older patients with PDs, as they might benefit from more schema therapy sessions, similar to the treatment dosage in younger PD patients. They might also benefit from a combination of group therapy and individual treatment sessions
Clinical pharmacokinetics and metabolism of irinotecan (CPT-11)
CPT-11 belongs to the class of topoisomerase I inhibitors, and it acts as
a prodrug of SN-38, which is approximately 100-1000-fold more cytotoxic
than the parent drug. CPT-11 has shown a broad spectrum of antitumor
activity in preclinical models as well as clinically, with responses
observed in various disease types including colorectal, lung, cervical,
and ovarian cancer. The pharmacokinetics and metabolism of CPT-11 are
extremely complex and have been the subject of intensive investigation in
recent years. Both CPT-11 and SN-38 are known in an active lactone form
and an inactive carboxylate form, between which an equilibrium exists that
depends on the pH and the presence of binding proteins. CPT-11 is subject
to extensive metabolic conversion by various enzyme systems, including
esterases to form SN-38, UGT1A1 mediating glucuronidation of SN-38, as
well as CYP3A4, which forms several pharmacologically inactive oxidation
products. Elimination routes of CPT-11 also depend on the presence of
drug-transporting proteins, notably P-glycoprotein and canalicular
multispecific organic anion transporter, present on the bile canalicular
membrane. The various processes mediating drug elimination, either through
metabolic breakdown or excretion, likely impact substantially on
interindividual variability in drug handling. Strategies to individualize
CPT-11 administration schedules based on patient differences in enzyme or
protein expression or by coadministration of specific agents modulating
side effects are under way and may ultimately lead to more selective
chemotherapeutic use of this agent
Lossâofâfunction mutations in CSF3R cause moderate neutropenia with fully mature neutrophils: two novel pedigrees
Death by request in The Netherlands: facts, the legal context and effects on physicians, patients and families
In this article I intend to describe an issue of the Dutch euthanasia practice that is not common knowledge. After some general introductory descriptions, by way of formulating a frame of reference, I shall describe the effects of this practice on patients, physicians and families, followed by a more philosophical reflection on the significance of these effects for the assessment of the authenticity of a request and the nature of unbearable suffering, two key concepts in the procedure towards euthanasia or physician-assisted suicide. This article does not focus on the arguments for or against euthanasia and the ethical justification of physician-assisted dying. These arguments have been described extensively in Kimsma and Van Leeuwen (Asking to die. Inside the Dutch debate about euthanasia, Kluwer Academic Publishers, Dordrecht, 1998)
Meticillin-resistant Staphylococcus aureus CC398 is an increasing cause of disease in people with no livestock contact in Denmark, 1999 to 2011
The TA Framework: Designing Real-time Teaching Augmentation for K-12 Classrooms
Recently, the HCI community has seen increased interest in the design of
teaching augmentation (TA): tools that extend and complement teachers'
pedagogical abilities during ongoing classroom activities. Examples of TA
systems are emerging across multiple disciplines, taking various forms: e.g.,
ambient displays, wearables, or learning analytics dashboards. However, these
diverse examples have not been analyzed together to derive more fundamental
insights into the design of teaching augmentation. Addressing this opportunity,
we broadly synthesize existing cases to propose the TA framework. Our framework
specifies a rich design space in five dimensions, to support the design and
analysis of teaching augmentation. We contextualize the framework using
existing designs cases, to surface underlying design trade-offs: for example,
balancing actionability of presented information with teachers' needs for
professional autonomy, or balancing unobtrusiveness with informativeness in the
design of TA systems. Applying the TA framework, we identify opportunities for
future research and design.Comment: to be published in Proceedings of the 2020 CHI Conference on Human
Factors in Computing Systems, 17 pages, 10 figure
Giving A Face to Chemotherapy-Induced Alopecia: A Feasibility Study on Drawings by Patients
Objective: Individuals with cancer experience the impact of chemotherapy on hair loss in different ways. The aim of this pilot study was to explore patients' experiences of alopecia through patients' drawings. Methods: Fifteen female patients diagnosed with cancer and treated with chemotherapy were recruited at the oncological day-care unit of a teaching hospital in the Netherlands. Participants completed a semi-structured interview about alopecia. They drew their head and hair before and during chemotherapy and completed the Brief Illness Perception Questionnaire (B-IPQ).Results: The drawings revealed predominantly physical effects, rather than emotions. Emotions were evident in the text that patients wrote under the drawings and in the B-IPQ open question about the perceived consequences of alopecia. The overall impact of alopecia that emerged from the drawings and the B-IPQ corresponded to the information retrieved from the interviews, namely disappointment, insecurity, sadness, and confrontation.Conclusions: Drawings expose cognitive and emotional responses to alopecia that may be relatively unexplored when using traditional assessment methods such as questionnaires or interviews. In future research, the drawing instructions need to be more specifically focused on feelings in order to better capture emotional reactions to hair loss.Experimentele farmacotherapi
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