ICU diaries: The journey to psychological recovery for critically ill patient\u27s family members

Session presented on Saturday, July 26, 2014: Purpose: Delusional memories from the period of critical illness have been shown to be a major contributor to the later occurrence of post traumatic stress disorder (PTSD). The experience of watching the patient being critically ill is also traumatic to families, making them at risk of PTSD. It was hypothesised that an ICU diary could help patients and their families come to terms with their differing memories and so reduce the incidence of PTSD. Methods: A prospective randomised, controlled study was performed in 12 ICUs across 6 European countries. 1 week after ICU discharge the ICU Memory Tool was used to identify recall for delusional memories. 1 month post ICU discharge PTSD related symptoms was assessed using the PTSS-14 and the patients were randomised to receive their diary at this point or after the next interview 3 months post ICU discharge. At 3 months a diagnosis of PTSD was made using the PDS. After the final interview, the control patients also received their diaries. In 2 of the study ICUs relatives were asked to complete the PTSS-14 at 1 month and 3 months post ICU discharge. Results: 352 patients were randomised, 322 (91.5%) completing the 3 month follow-up. 11 patients with undiagnosed, pre-existing PTSD were excluded from the final analysis. The incidence of new PTSD in the intervention group was 5% (8/154), and 13.4% (21/157) in the control group; this was statistically significant (p = 0.013). 30 relatives (15 in the intervention group and 15 in the control group) completed questionnaires at 1 and 3 months. Relatives in the intervention group had reduced PTSD symptom (P = .03). Conclusion: This randomised, controlled trial confirms that an ICU Diary helps patients come to terms with critical illness and reduces PTSD incidence. In addition the diary helps reduce symptoms of PTSD in relatives

Quantum Mechanical Conduction of Electrons in 1D Fibonacci Quasicrystals

Abstract In this report we model and study the propagation of electrons in one-dimensional (1D) Fibonacci quasicrystals. The quasicrystals are modeled with delta function potentials and created by either arranging their strengths or their spacings as a 2 letter Fibonacci word. The transmission and reflection amplitudes are calculated using an iterative method. A comparison is made against an ordinary crystal and a semi-random setup. The transmission of electrons are investigated and related to the electrical conduction in the different types of materials. We also investigate how sensitive the quasicrystals are to perturbations, compared to crystals. Finally, a quasicrystal modeled with a 3 letter Fibonacci word is discussed. We find that the Fibonacci structure increases the resistance by a relatively large factor, which makes the quasicrystals act like semiconductors. We also find tendencies that the quasicrystals are more sensitive to perturbations compared to ordinary crystals. The results are in good agreement with similar, earlier studies, both theoretical and experimental

Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a randomised, controlled trial

INTRODUCTION: Patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD). This study was to evaluate whether a prospectively collected diary of a patient's intensive care unit (ICU) stay when used during convalescence following critical illness will reduce the development of new onset PTSD. METHODS: Intensive care patients with an ICU stay of more than 72 hours were recruited to a randomised controlled trial examining the effect of a diary outlining the details of the patients ICU stay on the development of acute PTSD. The intervention patients received their ICU diary at 1 month following critical care discharge and the final assessment of the development of acute PTSD was made at 3 months. RESULTS: 352 patients were randomised to the study at 1 month. The incidence of new cases of PTSD was reduced in the intervention group compared to the control patients (5% versus 13%, P = 0.02). CONCLUSIONS: The provision of an ICU diary is effective in aiding psychological recovery and reducing the incidence of new PTSD.RACHEL GROUP in addition to the authors: Denmark, Christensen D, Bogø I, Hansen R, Kjerrumgård H, Mathiasen L, Hyldested C, Toft C, Nordsjaelland Hospital; Bagger C, Larsen MB, Frank de Jong L, Odense University Hospital; Ågård AS, Knudsen K, Hinzel T, Århus University Hospital, Skejby; Italy, Scaramuzza A &amp; Bertacchini S, Ferrara; Norway, Schou Landmark J, Salomonsen A, Tøien K, Walther S, Oslo University Hospital Ulleval; Muri AK, Haukeland University Hospital; Portugal, Neutel E, Gomes E, Cardoso T, Ferreira R, Machado C, Santos C, Pinto S, Hospital Santo António - Centro Hospitalar do Porto, Amaro A, Morujão E, Jerónimo A, Rodrigues T, Carvalho F, Silva A, Morais A Hospital Pedro Hispano; Sweden, Löwenmark U, Etemad W, Rosell E, Sahgrenska University Hospital; Carlson U, Wirbrand Holmquist A, Kungälv Hospital; Åkerman E, Ersson A, Malmö University Hospital; UK, Tobin C, Whiston.</p

The variability of urban aerosol size distributions and optical properties in São Paulo – Brazil: new particle formation events occur at the site

Non peer reviewe

Differences in aerosol absorption Ångström exponents between correction algorithms for particle soot absorption photometer measured on South African Highveld

Peer reviewe

NMDA Receptors on Non-Dopaminergic Neurons in the VTA Support Cocaine Sensitization

The initiation of behavioral sensitization to cocaine and other psychomotor stimulants is thought to reflect N-methyl-D-aspartate receptor (NMDAR)-mediated synaptic plasticity in the mesolimbic dopamine (DA) circuitry. The importance of drug induced NMDAR mediated adaptations in ventral tegmental area (VTA) DA neurons, and its association with drug seeking behaviors, has recently been evaluated in Cre-loxp mice lacking functional NMDARs in DA neurons expressing Cre recombinase under the control of the endogenous dopamine transporter gene (NR1(DATCre) mice).Using an additional NR1(DATCre) mouse transgenic model, we demonstrate that while the selective inactivation of NMDARs in DA neurons eliminates the induction of molecular changes leading to synaptic strengthening, behavioral measures such as cocaine induced locomotor sensitization and conditioned place preference remain intact in NR1(DATCre) mice. Since VTA DA neurons projecting to the prefrontal cortex and amygdala express little or no detectable levels of the dopamine transporter, it has been speculated that NMDA receptors in DA neurons projecting to these brain areas may have been spared in NR1(DATCre) mice. Here we demonstrate that the NMDA receptor gene is ablated in the majority of VTA DA neurons, including those exhibiting undetectable DAT expression levels in our NR1(DATCre) transgenic model, and that application of an NMDAR antagonist within the VTA of NR1(DATCre) animals still blocks sensitization to cocaine.These results eliminate the possibility of NMDAR mediated neuroplasticity in the different DA neuronal subpopulations in our NR1(DATCre) mouse model and therefore suggest that NMDARs on non-DA neurons within the VTA must play a major role in cocaine-related addictive behavior