Using group therapy to support eating disordered mothers with their children: the relevance for primary care

Eating disorders are a crippling and disabling condition. If they become chronic, the emotional, physical and social effects are substantial. The death rate is the highest of all psychiatric illnesses so the need to find prevention strategies is urgent. This research project has three aims, primary prevention of an eating disorder for the child, helping the mother recover and developing a protocol for a group to be used in primary care. Children of mothers with an eating disorder, are a proven ‘at risk’ group, because children model and internalize their experiences. This project was carried out in a community setting, targeting mothers with an eating disorder who had children under the age of 13. It was argued that if these mothers can be encouraged to change the dysfunctional behaviour they may be passing on to their children, an attempt can be made to break the cycle. This qualitative research pilot project utilized semi-structured interviews before and after 11 weeks of group therapy, with three- and six-month follow-ups. Although the sample was small, the results showed that a group allowed these mothers a safe space for reflection, enabling them to become aware of their behaviour. As a result the mothers implemented changes in response to their children's needs, encouraging healthier development. The pilot was a precursor for a larger study to be carried out and developed within the primary care network

The relationship of codependence to career choice

The purpose of this study was to investigate the possible correlation between codependency and career choice. A review of the literature seems to indicate that the helping professions attract people who are prone to codependency. For this reason, this study focused on four groups of undergraduate students: nursing students, psychology students, and social work majors, as the helping profession students, and students majoring in business-related fields. The study was also designed to provide empirical evidence to conplement the descriptive studies which have been the main source of information available up to the present time.;Subjects were drawn from students attending Christopher Newport College and Riverside Regional Medical Center\u27s School of Professional Nursing. Each group consisted of 40 students.;Subjects were asked to complete three self-report inventories: The Moos Family Environment Scale (FES), The Adjective Check List (ACL), (Real and Ideal), and The Behavioral Assessment Inventory, which was actually the Friel Codependency Assessment Inventory (FCDI) combined with the L and K scales of the MMPI.;It was hypothesized that: Students in helping professions will score higher on the Behavioral Assessment Inventory than business students; Students in helping professions will show a larger discrepancy between Real and Ideal Self on the ACL and will also score higher on the Nurturance and Abasement scales of the ACL than business students; and students in the helping professions will score higher on the Conflict and Control scales of the FES than business students.;None of the results were significant at the 0.05 level. However, an artifact of the research indicates there is a significant difference on the K scale (incorporated in the FCDI) (t = 2.79, p {dollar}\u3c{dollar}.05) between helping profession and business students

Marshall University Department of Music presents a Senior Recital Karen Barnett, trombone

https://mds.marshall.edu/music_perf/1050/thumbnail.jp

Protocol for the effective feedback to improve primary care prescribing safety (EFIPPS) study : a cluster randomised controlled trial using ePrescribing data

High-risk prescribing in primary care is common and causes considerable harm. Feedback interventions to improve care are attractive because they are relatively cheap to widely implement. There is good evidence that feedback has small to moderate effects, but the most recent Cochrane review called for more high-quality, large trials that explicitly test different forms of feedback. The study is a three-arm cluster-randomised trial with general practices being randomised and outcomes measured at patient level. 262 practices in three Scottish Health Board areas have been randomised (94% of all possible practices). The two active arms receive different forms of prescribing safety data feedback, with rates of high-risk prescribing compared with a ‘usual care’ arm. Sample size estimation used baseline data from participating practices. With 85 practices randomised to each arm, then there is 93% power to detect a 25% difference in the percentage of high-risk prescribing (from 6.1% to 4.5%) between the usual care arm and each intervention arm. The primary outcome is a composite of six high-risk prescribing measures (antipsychotic prescribing to people aged ≥75 years; non-steroidal anti-inflammatory drug (NSAID) prescribing to people aged ≥75 without gastroprotection; NSAID prescribing to people prescribed aspirin/clopidogrel without gastroprotection; NSAID prescribing to people prescribed an ACE inhibitor/angiotensin receptor blocker and a diuretic; NSAID prescription to people prescribed an oral anticoagulant without gastroprotection; aspirin/clopidogrel prescription to people prescribed an oral anticoagulant without gastroprotection). The primary analysis will use multilevel modelling to account for repeated measurement of outcomes in patients clustered within practices. The study was reviewed and approved by the NHS Tayside Committee on Medical Research Ethics B (11/ES/0001). The study will be disseminated via a final report to the funder with a publicly available research summary, and peer reviewed publications

Role of IL-33 and ST2 signalling pathway in multiple sclerosis: expression by oligodendrocytes and inhibition of myelination in central nervous system

Recent research findings have provided convincing evidence indicating a role for Interleukin-33 (IL-33) signalling pathway in a number of central nervous system (CNS) diseases including multiple sclerosis (MS) and Alzheimer’s disease. However, the exact function of IL-33 molecule within the CNS under normal and pathological conditions is currently unknown. In this study, we have mapped cellular expression of IL-33 and its receptor ST2 by immunohistochemistry in the brain tissues of MS patients and appropriate controls; and investigated the functional significance of these findings in vitro using a myelinating culture system. Our results demonstrate that IL-33 is expressed by neurons, astrocytes and microglia as well as oligodendrocytes, while ST2 is expressed in the lesions by oligodendrocytes and within and around axons. Furthermore, the expression levels and patterns of IL-33 and ST2 in the lesions of acute and chronic MS patient brain samples are enhanced compared with the healthy brain tissues. Finally, our data using rat myelinating co-cultures suggest that IL-33 may play an important role in MS development by inhibiting CNS myelination

Faecal Haemoglobin Estimated by Faecal Immunochemical Tests:An Indicator of Systemic Inflammation with Real Clinical Potential

Multimorbidity is the major cause of ill-health and premature death in developed countries. The ability to identify individuals at risk of developing chronic disease, particularly multimorbidity, reliably, and simply, and to identify undiagnosed disorders, is vital to reducing the global burden of disease. This narrative review, the first of recent studies, demonstrates that raised faecal haemoglobin concentration (f-Hb) is associated with increased all-cause and cause-specific mortality and with longer-term conditions including diabetes, hypertension, cardiovascular disease, and psoriasis, and with probable intake of particulate matter. We and others have hypothesized that elevated f-Hb (measured using a faecal immunochemical test) has considerable potential to identify individuals at risk of, or who already have, early stage, undiagnosed chronic disease. If f-Hb does prove to be an effective biomarker for chronic disease and multimorbidity, individuals with detectable f-Hb, but without an obvious source of gastrointestinal blood loss, could benefit from further assessment and early intervention. To test this hypothesis rigorously, longitudinal data-linkage methodology is required linking colorectal cancer screening data, and data on patients presenting with lower gastrointestinal symptoms, with routinely collected health information

Doing the ‘write’ thing: handwriting and typing support in secondary schools in England

Students must be able to produce legible and fluent text when completing classwork and for exam purposes. Some students, however, present with handwriting difficulties in secondary school. When these are significant, intervention may be necessary or alternatives to handwriting may be offered (e.g. use of a word processor). Little is known about current practice of supporting secondary students with handwriting difficulties in England and how recommendations are made to transition to typing. Semi-structured interviews were conducted with 13 practitioners with a responsibility for supporting students with handwriting difficulties. Two themes were identified. The first theme, ‘doing the right thing’, illustrated the tension between practitioners' commitment to supporting students with handwriting difficulties and their uncertainty around what is the ‘right’ approach. The second theme, ‘influencing practice’, described the contextual factors (student and family, school environment and national context) that impact on practitioners' practice and their decision to transition from handwriting to typing. Findings highlight the complexities of supporting this group of students and an urgent need for guidance at a national level to assist best practice. Implications for practice are discussed. Further research examining the effectiveness of handwriting interventions with secondary students and the optimum time to start typing is warranted

Effect of Primary Care Intervention on Breastfeeding Duration and Intensity

Objectives. We determined the effectiveness of primary care–based, and pre- and postnatal interventions to increase breastfeeding. Methods. We conducted 2 trials at obstetrics and gynecology practices in the Bronx, New York, from 2008 to 2011. The Provider Approaches to Improved Rates of Infant Nutrition & Growth Study (PAIRINGS) had 2 arms: usual care versus pre- and postnatal visits with a lactation consultant (LC) and electronically prompted guidance from prenatal care providers (EP). The Best Infant Nutrition for Good Outcomes (BINGO) study had 4 arms: usual care, LC alone, EP alone, or LC+EP. Results. In BINGO at 3 months, high intensity was greater for the LC+EP (odds ratio [OR] = 2.72; 95% confidence interval [CI] = 1.08, 6.84) and LC (OR = 3.22; 95% CI = 1.14, 9.09) groups versus usual care, but not for the EP group alone. In PAIRINGS at 3 months, intervention rates exceeded usual care (OR = 2.86; 95% CI = 1.21, 6.76); the number needed to treat to prevent 1 dyad from nonexclusive breastfeeding at 3 months was 10.3 (95% CI = 5.6, 50.7). Conclusions. LCs integrated into routine care alone and combined with EP guidance from prenatal care providers increased breastfeeding intensity at 3 months postpartum