Refugees Who Have Experienced Extreme Cruelty: A Qualitative Study of Mental Health and Wellbeing after Being Granted Leave to Remain in the UK

This study explores how vulnerable refugees’ experiences in the first year after being granted leave to remain in the UK impact on mental health and wellbeing. Nine semi-structured interviews were conducted with refugee survivors of extreme cruelty. Data were analyzed using thematic analysis with a narrative influence. Reported challenges included requirements to organize housing, finances and welfare benefits rapidly. Most respondents reported low mood, worry, exacerbated PTSD symptoms, physical ailments and isolation, but valued stable housing, meaningful activities, emotional support and service provider sensitivity in managing this transition. Policy and service recommendations are made, to assist integration and improve wellbeing

Monetary costs of agitation in older adults with Alzheimer's disease in the UK: prospective cohort study

While nearly half of all people with Alzheimer's disease (AD) have agitation symptoms every month, little is known about the costs of agitation in AD. We calculated the monetary costs associated with agitation in older adults with AD in the UK from a National Health Service and personal social services perspective

Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials.

Background Agitation in dementia is common, persistent and distressing and can lead to care breakdown. Medication is often ineffective and harmful. Aims To systematically review randomised controlled trial evidence regarding non-pharmacological interventions. Method We reviewed 33 studies fitting predetermined criteria, assessed their validity and calculated standardised effect sizes (SES). Results Person-centred care, communication skills training and adapted dementia care mapping decreased symptomatic and severe agitation in care homes immediately (SES range 0.3-1.8) and for up to 6 months afterwards (SES range 0.2-2.2). Activities and music therapy by protocol (SES range 0.5-0.6) decreased overall agitation and sensory intervention decreased clinically significant agitation immediately. Aromatherapy and light therapy did not demonstrate efficacy. Conclusions There are evidence-based strategies for care homes. Future interventions should focus on consistent and long-term implementation through staff training. Further research is needed for people living in their own homes

Narrative exposure therapy for survivors of human trafficking: feasibility randomised controlled trial

Background Human trafficking is a grave human rights violation and a major public health concern. Survivors present with high rates of mental health problems including post-traumatic stress disorder (PTSD). Studies of effective treatments for PTSD in survivors of human trafficking are lacking. Narrative exposure therapy (NET) is an effective PTSD treatment for multiple, prolonged and complex trauma, but its efficacy has not been rigorously tested in survivors of human trafficking. Aims To test the feasibility and acceptability of a randomised controlled trial (RCT) offering NET as a treatment for PTSD in trafficking survivors with a history of multiple traumatic events, as well as providing preliminary evidence regarding its efficacy (trial registration: ISRCTN95136302). Method A single-blind RCT compared NET with a wait-list control in survivors of trafficking with PTSD (n = 25). In the NET arm of the study, participants attended a mean of 17 sessions. Results NET was well tolerated by participants. There were significant reductions in PTSD, depression and anxiety symptoms post-treatment in the NET group but no significant change in the wait-list group. Conclusions The results indicate that NET is a promising and acceptable treatment for trafficking survivors. Psychological therapy in an RCT design can be safely delivered to this vulnerable group, although modifications are required to ensure their holistic needs are properly addressed

Pre-operative psychiatric morbidity in people undergoing cataract surgery.

Background. The aim of our research was to examine the impact of depressive symptomatology and cognitive impairment on visual function and symptoms in patients with cataract. Material and methods. Demographic details, ophthalmological details, Snellen acuity, cataract symptoms, visual function, depressive symptomatology, cognitive impairment and quality of life were measured in 72 elderly subjects attending the pre-assessment cataract clinic at the Herts and Essex Hospital, Bishops Stortford, England. Results. Subjects with depressive symptomatology were significantly more affected by symptoms of cataract (Spearman = 0.039, p<0.05) and had poorer visual functioning (Spearman = 0.023, p<0.05) than their non-depressed counterparts, despite no significant difference in visual acuity between the two groups. There were no significant differences for subjects with cognitive impairment and cataract symptoms (Spearman = 0.700, NS) or visual functioning (Spearman = 0.158, NS). Conclusions. The study supports the hypothesis that depressive symptomatology is related to pre-operative cataract symptoms and visual functioning, but did not confirm that cognitive impairment was related to pre-operative cataract symptoms or level of visual function

Narrative exposure therapy for survivors of human trafficking: feasibility randomised controlled trial

BACKGROUND: Human trafficking is a grave human rights violation and a major public health concern. Survivors present with high rates of mental health problems including post-traumatic stress disorder (PTSD). Studies of effective treatments for PTSD in survivors of human trafficking are lacking. Narrative exposure therapy (NET) is an effective PTSD treatment for multiple, prolonged and complex trauma, but its efficacy has not been rigorously tested in survivors of human trafficking. AIMS: To test the feasibility and acceptability of a randomised controlled trial (RCT) offering NET as a treatment for PTSD in trafficking survivors with a history of multiple traumatic events, as well as providing preliminary evidence regarding its efficacy (trial registration: ISRCTN95136302). METHOD: A single-blind RCT compared NET with a wait-list control in survivors of trafficking with PTSD (n = 25). In the NET arm of the study, participants attended a mean of 17 sessions. RESULTS: NET was well tolerated by participants. There were significant reductions in PTSD, depression and anxiety symptoms post-treatment in the NET group but no significant change in the wait-list group. CONCLUSIONS: The results indicate that NET is a promising and acceptable treatment for trafficking survivors. Psychological therapy in an RCT design can be safely delivered to this vulnerable group, although modifications are required to ensure their holistic needs are properly addressed

Regular dendritic patterns induced by non-local time-periodic forcing

The dynamic response of dendritic solidification to spatially homogeneous time-periodic forcing has been studied. Phase-field calculations performed in two dimensions (2D) and experiments on thin (quasi 2D) liquid crystal layers show that the frequency of dendritic side-branching can be tuned by oscillatory pressure or heating. The sensitivity of this phenomenon to the relevant parameters, the frequency and amplitude of the modulation, the initial undercooling and the anisotropies of the interfacial free energy and molecule attachment kinetics, has been explored. It has been demonstrated that besides the side-branching mode synchronous with external forcing as emerging from the linear Wentzel-Kramers-Brillouin analysis, modes that oscillate with higher harmonic frequencies are also present with perceptible amplitudes.Comment: 15 pages, 23 figures, Submitted to Phys. Rev.

World psychiatric association section of old age psychiatry consensus statement on ethics and capacity in older people with mental disorders

The World Psychiatric Association (WPA) Section of Old Age Psychiatry, since 1997, has developed Consensus Statements relevant to the practice of Old Age Psychiatry. Since 2006 the Section has worked to develop a Consensus Statement on Ethics and Capacity in older people with mental disorders, which was completed in Prague, September 2008, prior to the World Congress in Psychiatry. This Consensus meets one of the goals of the WPA Action Plan 2008–2011, ”to promote the highest ethical standards in psychiatric practice and advocate the rights of persons with mental disorders in all regions of the world“. This Consensus Statement offers to mental health clinicians caring for older people with mental disorders, caregivers, other health professionals and the general public the setting out of and discourse in ethical principles which can often be complex and challenging, supported by practical guidance in meeting such ethical needs and standards, and to encouraged good clinical practice. Copyright © 2009 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/64443/1/2279_ftp.pd

The Current-Temperature Phase Diagram of Layered Superconductors

The behavior of clean layered superconductors in the presence of a finite electric current and in zero-magnetic field behavior is addressed. The structure of the current temperature phase diagram and the properties of each of the four regions will be explained. We will discuss the expected current voltage and resistance characteristics of each region as well as the effects of finite size and weak disorder on the phase diagram. In addition, the reason for which a weakly non-ohmic region exists above the transition temperature will be explained.Comment: 8 pages (RevTeX), 4 encapsulated postscript figure

Detection of Early-Stage Pancreatic Ductal Adenocarcinoma From Blood Samples : Results of a Multiplex Biomarker Signature Validation Study

INTRODUCTION: The IMMray PanCan-d test combines an 8-plex biomarker signature with CA19-9 in a proprietary algorithm to detect pancreatic ductal adenocarcinoma (PDAC) in serum samples. This study aimed to validate the clinical performance of the IMMray PanCan-d test and to better understand test performance in Lewis-null (le/le) individuals who cannot express CA19-9. METHODS: Serum samples from 586 individuals were analyzed with the IMMray PanCan-d biomarker signature and CA19-9 assay, including 167 PDAC samples, 203 individuals at high risk of familial/hereditary PDAC, and 216 healthy controls. Samples were collected at 11 sites in the United States and Europe. The study was performed by Immunovia, Inc (Marlborough, MA), and sample identity was blinded throughout the study. Test results were automatically generated using validated custom software with a locked algorithm and predefined decision value cutoffs for sample classification. RESULTS: The IMMray PanCan-d test distinguished PDAC stages I and II (n = 56) vs high-risk individuals with 98% specificity and 85% sensitivity and distinguished PDAC stages I-IV vs high-risk individuals with 98% specificity and 87% sensitivity. We identified samples with a CA19-9 value of 2.5 U/mL or less as probable Lewis-null (le/le) individuals. Excluding these 55 samples from the analysis increased the IMMray PanCan-d test sensitivity to 92% for PDAC stages I-IV (n = 157) vs controls (n = 379) while maintaining specificity at 99%; test sensitivity for PDAC stages I and II increased from 85% to 89%. DISCUSSION: These results demonstrate the IMMray PanCan-d blood test can detect PDAC with high specificity (99%) and sensitivity (92%).Peer reviewe