Następstwa zdrowotne pracy w narażeniu na leki cytostatyczne w grupie zawodowej pielęgniarek i pielęgniarzy = The health consequences of occupational exposure to cytostatics among nurses

Cieślicka Agnieszka, Gębka Magda, Rząca Marcin, Kocka Katarzyna, Pietraszek Agata, Bartoszek Agnieszka, Charzyńska‑Gula Marianna. Następstwa zdrowotne pracy w narażeniu na leki cytostatyczne w grupie zawodowej pielęgniarek i pielęgniarzy = The health consequences of occupational exposure to cytostatics among nurses. Journal of Education, Health and Sport. 2016;6(9):566-574. eISSN 2391-8306. DOI 1http://dx.doi.org/10.5281/zenodo.154995http://ojs.ukw.edu.pl/index.php/johs/article/view/3882    The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015).755 Journal of Education, Health and Sport eISSN 2391-8306 7© The Author (s) 2016;This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, PolandOpen Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium,provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License(http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited.This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercialuse, distribution and reproduction in any medium, provided the work is properly cited.The authors declare that there is no conflict of interests regarding the publication of this paper.Received: 05.08.2016. Revised 25.08.2016. Accepted: 21.09.2016.   Następstwa zdrowotne pracy w narażeniu na leki cytostatyczne w grupie zawodowej pielęgniarek i pielęgniarzy The health consequences of occupational exposure to cytostatics among nurses Agnieszka Cieślicka1, Magda Gębka2, Marcin Rząca3, Katarzyna Kocka4, Agata Pietraszek3, Agnieszka Bartoszek4, Marianna Charzyńska-Gula5 1. Blok Operacyjny, Samodzielny Publiczny Szpital Kliniczny nr 4 w Lublinie2. Oddział Chirurgii Naczyniowej, Wojewódzki Szpital Specjalistyczny im. Stefana Kardynała Wyszyńskiego w Lublinie3. Zakład Onkologii, Katedra Onkologii i Środowiskowej Opieki Zdrowotnej, Uniwersytet Medyczny w Lublinie4. Zakład Medycyny Rodzinnej i Pielęgniarstwa Środowiskowego, Katedra Onkologii i Środowiskowej Opieki Zdrowotnej, Uniwersytet Medyczny w Lublinie5. Wydział Nauk Społecznych i Humanistycznych, Państwowa Wyższa Szkoła im. prof. Stanisława Tarnowskiego w Tarnobrzegu  StreszczenieWprowadzenie. Stosowane w leczeniu przeciwnowotworowym leki cytostatyczne działają toksycznie nie tylko na komórki nowotworowe, ale także na zdrowe. Przyjęcie chemioterapii wiąże się z występowaniem u pacjentów licznych, mocno nasilonych objawów niepożądanych. Kontakt z tymi lekami ma także personel. Toksyczne cytostatyki są wchłaniane przez personel drogą wziewną, kontaktową przez skórę, co ma miejsce nie tylko podczas przygotowywania i podawania leków przez personel pielęgniarski ale także przez kontakt z wydzielinami pacjentów. Ich wpływ na zdrowie pielęgniarek i pielęgniarzy nie jest obojętny.Cel. Celem badań było zbadanie następstw zdrowotnych pracy w narażeniu na leki cytostatyczne w grupie zawodowej pielęgniarek i pielęgniarzy.Materiał i metody. Uczestnikami badania były pielęgniarki i pielęgniarze lubelskich szpitali w liczbie 97 osób, podający pacjentom i/lub przygotowujący leki cytostatyczne. Narzędzia badawczym był autorski kwestionariusz ankiety, składający się z 14 pytań.Wyniki. Personel pielęgniarski pracujący w narażeniu na leki cytostatyczne obserwował u siebie następujące objawy: nadmierne łzawienie, suchość spojówek, zaczerwienienie i swędzenie oczu (47%), podrażnienie skóry (44%), podrażnienie błon śluzowych (39%), nasilone wypadanie brwi, rzęs (30%) czy odczuwanie zaburzeń rytmu serca (16%) oraz nudności/wymioty (8%). Nie wszyscy pracownicy stosowali podczas podawania leków środki ochrony osobistej, fartuch flizelinowy- stosowało 64% badanych, maskę na twarz 61% a okulary ochronne 36% badanych.Wnioski. Najwięcej objawów spowodowanych pracą w środowisku chemioterapeutyków występuje u osób z najdłuższym stażem pracy w narażeniu na leki cytostatyczne. liczba podawanych cytostatyków pacjentom tygodniowo istotnie wiąże się ze znacznie  częstszym występowaniem niepokojących zmian w organizmie, wywołanych najprawdopodobniej kontaktem z tymi lekami.Personel pielęgniarski stosuje środki ochrony indywidualnej w sposób niewystarczający.Słowa kluczowe. personel pielęgniarski, cytostatyki, powikłania, narażenie zawodowe SummaryIntroduction. Cytostatics used in cancer treatment are toxic not only for cancerous lesions but also for normal cells. Chemotherapy causes a number of strong adverse reactions experienced by patients. The personnel is also exposed to these drugs. The toxic cytostatics are absorbed by the personnel by inhaling and through contact with the skin, which takes place not only during preparing and administering the medications by nurses, but also through contact with patients' secretions. They have a noticeable impact on nurses' health.Aim. The aim of the survey was to assess the health consequences of occupational exposure to cytostatics among nurses.Material and method. The survey included 97 nurses working in Lublin's hospitals on the preparation and/or administration of cytostatics. A self-designed questionnaire consisting of 14 questions served as the research tool.Results. The nurses exposed to cytostatics demonstrated the following symptoms: excessive lacrimation, dry conjunctivas, eye redness and itching (47%), skin irritation (44%), irritated mucous membranes (39%), increased eyebrow and lash shedding (30%), cardiac arrhythmia (16%), and nausea/vomiting (8%). Not all of the employees used personal protection equipment while administering the drugs; protective non-woven aprons - 64% of the surveyed, face mask - 61%, protective glasses - 36%.Conclusion. The highest number of symptoms caused by contact with chemotherapeutics is observed among people exposed to cytostatics for the longest period of time.The amount of cytostatics administered to patients per week is significantly correlated with the frequency of alarming changes in the nurses' systems, probably caused by contact with the medications.Furthermore, nurses do not make a sufficient use of personal protection equipment.Key words. nurses, cytostatics, complications, occupational exposur

Understanding the impact of brain disorders: Towards a 'horizontal epidemiology' of psychosocial difficulties and their determinants

Objective To test the hypothesis of ‘horizontal epidemiology’, i.e. that psychosocial difficulties (PSDs), such as sleep disturbances, emotional instability and difficulties in personal interactions, and their environmental determinants are experienced in common across neurological and psychiatric disorders, together called brain disorders. Study Design A multi-method study involving systematic literature reviews, content analysis of patientreported outcomes and outcome instruments, clinical input and a qualitative study was carried out to generate a pool of PSD and environmental determinants relevant for nine different brain disorders, namely epilepsy, migraine, multiple sclerosis, Parkinson’s disease, stroke, dementia, depression, schizophrenia and substance dependency. Information from these sources was harmonized and compiled, and after feedback from external experts, a data collection protocol including PSD and determinants common across these nine disorders was developed. This protocol was implemented as an interview in a cross-sectional Objective To test the hypothesis of ‘horizontal epidemiology’, i.e. that psychosocial difficulties (PSDs), such as sleep disturbances, emotional instability and difficulties in personal interactions, and their environmental determinants are experienced in common across neurological and psychiatric disorders, together called brain disorders. Study Design A multi-method study involving systematic literature reviews, content analysis of patientreported outcomes and outcome instruments, clinical input and a qualitative study was carried out to generate a pool of PSD and environmental determinants relevant for nine different brain disorders, namely epilepsy, migraine, multiple sclerosis, Parkinson’s disease, stroke, dementia, depression, schizophrenia and substance dependency. Information from these sources was harmonized and compiled, and after feedback from external experts, a data collection protocol including PSD and determinants common across these nine disorders was developed. This protocol was implemented as an interview in a cross-sectionalThe PARADISE project is supported by the Coordination Theme 1 (Health) of the European Community’s FP7, Grant Agreement No. HEALTHF2- 2009-241572

Does employment promote the process of recovery from schizophrenia? A review of the existing evidence

The aim of this review is to appraise current evidence on the association between employment and specific, non-vocational components that are indicators of recovery from schizophrenia, such as symptom remission, neurocognitive functioning, social cognitive functioning, and quality of life. Out of 754 studies identified in a comprehensive bibliographical data search, 43 were selected for abstract screening and 18 were included in the final review. The studies were categorized in terms of the type of employment investigated (supported employment, Individual Placement and Support, competitive employment). Studies on the Individual Placement and Support programs provide the strongest evidence for their effectiveness in terms of non-vocational outcomes. Quality of life, psychopathology and well being were the most frequently investigated outcomes and only 2 studies utilized a global concept of recovery as a measure. Employment was also associated with positive changes in domains that are not directly related to working, e.g., leisure activities. The current review reports promising, but not conclusive, results in the improvement of quality of life, social functioning and other indicators of recovery, but there is still a need for high quality, long term follow-up, randomized studies to further investigate this relationship

Motives for the choice of not undergoing breast reconstruction

Introduction and objective. Currently, most women with less advanced breast cancer are offered operations with breast conserving treatment; however, if it is necessary to completely remove the breast, the patients may benefit from free breast reconstruction. The aim of the study was to determine the motives for breast reconstruction after mastectomy or decisive reasons for rejecting this treatment. Material and methods. The study included 241 women hospitalized in Polish oncological hospitals who were divided into two groups: 55.19% (n=133) were women after mastectomy; 44.81% (n=108) after breast reconstruction. Quantitative approach with the use of survey method was utilised. Results. Women who wished to undergo breast reconstruction were generallyy younger, better educated and more often professionally active. For women who wished to undergo breast reconstruction, the most important aspect was the willingness to improve their body image, their mental well-being, the inconvenience connected with wearing the prosthesis, better sexual relations with husband/partner, and the possibility of exposing the neckline without discomfort. The strongest correlation was found between women’s young age and their functioning in a relationship. Women after mastectomy, who decided not to undergo a breast reconstruction, were afraid of another operation, suffering, and they believed that there were more important issues. Conclusions. The study revealed a relationship between the lack of knowledge, in which hospital breast reconstruction procedure can be performed and the lack of motivation for undergoing the procedure. Women who have had knowledge of the possibility of a free breast reconstruction were younger, better educated and more often lived in the city

Motives for the choice of not undergoing breast reconstruction

Introduction and objective. Currently, most women with less advanced breast cancer are offered operations with breast conserving treatment; however, if it is necessary to completely remove the breast, the patients may benefit from free breast reconstruction. The aim of the study was to determine the motives for breast reconstruction after mastectomy or decisive reasons for rejecting this treatment. Material and methods. The study included 241 women hospitalized in Polish oncological hospitals who were divided into two groups: 55.19% (n=133) were women after mastectomy; 44.81% (n=108) after breast reconstruction. Quantitative approach with the use of survey method was utilised. Results. Women who wished to undergo breast reconstruction were generallyy younger, better educated and more often professionally active. For women who wished to undergo breast reconstruction, the most important aspect was the willingness to improve their body image, their mental well-being, the inconvenience connected with wearing the prosthesis, better sexual relations with husband/partner, and the possibility of exposing the neckline without discomfort. The strongest correlation was found between women’s young age and their functioning in a relationship. Women after mastectomy, who decided not to undergo a breast reconstruction, were afraid of another operation, suffering, and they believed that there were more important issues. Conclusions. The study revealed a relationship between the lack of knowledge, in which hospital breast reconstruction procedure can be performed and the lack of motivation for undergoing the procedure. Women who have had knowledge of the possibility of a free breast reconstruction were younger, better educated and more often lived in the city

Świadomość mężczyzn - studentów kierunków medycznych z różnych krajów na temat samobadania piersi przez kobiety i jego znaczenia w profilaktyce nowotworów

Pietraszek Agata, Charzyńska-Gula Marianna, Łuczyk Marta, Stanisławek Andrzej, Kozioł Anna, Kocka Katarzyna, Kocki Tomasz. Świadomość mężczyzn - studentów kierunków medycznych z różnych krajów na temat samobadania piersi przez kobiety i jego znaczenia w profilaktyce nowotworów = The awareness of male students of medical sciences from various countries related to breast self-examination among women and its importance for cancer prophylactics. Journal of Education, Health and Sport. 2015;5(9):493-504. ISSN 2391-8306. DOI10.5281/zenodo.31299 http://dx.doi.org/10.5281/zenodo.31299 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%289%29%3A493-504 https://pbn.nauka.gov.pl/works/631300 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014http://journal.rsw.edu.pl/index.php/JHS/issue/archive   Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 26.08.2015. Revised 05.09.2015. Accepted: 22.09.2015.   Świadomość mężczyzn - studentów kierunków medycznych z różnych krajów na temat samobadania piersi przez kobiety i jego znaczenia w profilaktyce nowotworów The awareness of male students of medical sciences from various countries related to breast self-examination among women and its importance for cancer prophylactics Agata Pietraszek 1, Marianna Charzyńska-Gula2, Marta Łuczyk1, Andrzej Stanisławek1, Anna Kozioł3, Katarzyna Kocka1, Tomasz Kocki4 • 1.      Katedra Onkologii i Środowiskowej Opieki Zdrowotnej, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie, Polska • 2.      Wydział Nauk Społecznych i Humanistycznych, Państwowa Wyższa Szkoła Zawodowa im. prof. Stanisława Tarnowskiego w Tarnobrzegu, Polska • 3.      Samodzielny Publiczny Szpital Kliniczny nr 4 w Lublinie, Polska • 4.      Katedra i Zakład Farmakologii Doświadczalnej i Klinicznej, II Wydział Lekarski z Oddziałem Anglojęzycznym, Uniwersytet Medyczny w Lublinie, Polska   Streszczenie Cel pracy: Poznanie świadomości mężczyzn różnych narodowości studiujących nauki medyczne na temat samobadania piersi jako metody wczesnego wykrywania raka piersi oraz opisanie podstawowych uwarunkowań przejawianych przekonań i poglądów. Materiał i metody: Badania przeprowadzono wśród 208 studentów medycyny z Polski oraz krajów obcojęzycznych. Wszyscy respondenci studiowali na lubelskiej uczelni medycznej. Narzędziem badawczym zastosowanym w pracy był autorski kwestionariusz ankiety stworzony dla potrzeb niniejszego badania. Wyniki: Większość respondentów nie posiadało wiedzy o tym, czy kobiety z ich otoczenia wykonują samobadanie piersi. Była to najczęstsza odpowiedz zarówno wśród mężczyzn z Polski jak i z zagranicy. Niemal ¼ respondentów z Polski i jedynie 16% studentów z zagranicy było pewnych, że kobiety z ich otoczenia badają swoje piersi. Nawet 72% ogółu respondentów twierdziło zdecydowanie, że samobadanie jest ważnym aspektem profilaktyki piersi. Odpowiedziało tak 84,44% respondentów z Polski i 62,71% respondentów z zagranicy. Wnioski: Mężczyźni z Polski istotnie częściej doceniali ważność samobadania w profilaktyce nowotworu piersi aniżeli ich zagraniczni koledzy. Dodatkowo to większość Polaków wskazywała prawidłowe odpowiedzi, w zakresie zasad samobadania piersi, aniżeli mężczyźni z innych krajów. Należy podjąć działania zwiększające świadomość oraz wiedzę mężczyzn na temat wczesnej profilaktyki nowotworu piersi wśród kobiet. Słowa kluczowe: wiedza o zdrowiu, postawy, profilaktyka, świadomość; zdrowie kobiety, samobadanie piersi.   Abstract Objective: To find out about the awareness among men of various nationalities studying medical sciences on breast self-examination as a method of the early detection of breast cancer and to describe the major determinants of the identified views and beliefs. Material and methods: The survey was carried out among 208 students of medicine from Poland and other countries. All the respondents studied at the Medical University of Lublin. A questionnaire prepared by the authors for the purposes of the study constituted the research instrument. Results: Most respondents did not have any knowledge on whether women in their nearest environment practiced breast self-examination. This was true both about men from Poland and from abroad. Almost one fourth of the respondents from Poland and only 16% of students from abroad were sure that women in their environment performed breast self-examination. As many as 72% of the surveyed were of the opinion that self-examination definitely is an important aspect of breast cancer prophylactics. The statement was confirmed by 84.44% of respondents from Poland and 62.71% of those from abroad. Conclusions: Men from Poland significantly more often recognised the significance of self-examination in breast cancer prophylactics than those from other countries. Furthermore, more Poles than men from other countries selected the correct answers to questions concerning breast self-examination. Therefore, measures should be taken to increase the awareness and knowledge of men about early breast cancer prophylactics among women. Key words: health knowledge, attitudes, practice, awareness, women’s health, breast self-examination

Knowledge and attitudes of the young people from post-secondary schools towards HIV/AIDS-preliminary study

Wprowadzenie Zakażenie ludzkim wirusem upośledzenia odporności (HIV) oraz nabyty zespół upośledzenia odporności (AIDS) są poważnymi problemami współczesnego świata. Obecnie świat walczy z AIDS, którego główną bronią są: długoletnia bezobjawowość, brak szczepionki oraz przejawy dyskryminacji ludzi nią dotkniętych. Cel pracy Celem pracy jest ocena poziomu wiedzy i postaw młodzieży na temat zagadnień dotyczących HIV/AIDS. Materiał i metoda 26 W pracy wykorzystano metodę sondażu diagnostycznego z zastosowaniem techniki ankiety. Badania ostały przeprowadzone wśród 149 uczniów szkoły ponadgimnazjalnej . Wyniki Młodzież w większości wie, jakie są drogi zakażenia wirusem HIV. Badani wiedzą, że AIDS jest chorobą nieuleczalną i znają pojęcie okienka serologicznego. Młodzież zna sposoby zabezpieczenia się przed zakażeniem i wie, że pierwszy stosunek z nosicielem wirusa HIV lub osobą chorą na AIDS grozi zakażeniem HIV. Badani w większości uważają, że postawa społeczeństwa wobec założonych HIV jest negatywna. Większość badanych nie obawiałaby się chodzić do tej samej klasy, co osoba zakażona wirusem HIV, zamieszkać w jednym domu z osobą chorą lub zakażoną a połowa nie odczuwałaby dyskomfortu pracując zawodowo z tymi osobami. Tylko 1/6 uczniów dopuszcza możliwość kontaktów towarzyskich z osobą zakażoną wirusem HIV lub chorą na AIDS. Większość uczniów nie obwinia chorych na AIDS, że przyczynili się do powstania choroby. Wnioski 1. Młodzież dysponuje tylko ogólnymi informacjami na temat AIDS i HIV . 2. W życiu codziennym większość z nich chroniłaby siebie przed zakażeniem poprzez szczególne zwracanie uwagi na kontakty seksualne i stosowanie prezerwatywy. 3. Obcy nosiciele HIV i chorzy na AIDS są odbierani poprzez młodzież jako poważne zagrożenie, natomiast bliskie im osoby których dotknie ta choroba nie są przez nich odrzucani.Introduction Infection with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are serious problems of the modern world. Currently, the world is struggling with AIDS, the main weapons of which include: long-term lack of symptoms, lack of vaccine and discrimination on the side of the people who are not affected by it. The purpose of the thesis The purpose of the thesis is to evaluate the level of knowledge and attitudes of young people toward issues relating to HIV/AIDS. Material and method A diagnostic survey method using survey technique was used in the thesis. The research was conducted among 149 students from a post-secondary school. Results In most cases, young people know the ways of HIV infection. The Respondents know that AIDS is an incurable disease and they are familiar with the concept of the serological window. Young people know how to protect themselves against infection and they know that the first intercourse with a HIV carrier or someone who has AIDS constitutes a risk of infection with HIV. In most cases, the Respondents think that the attitude of the society towards people infected with HIV is negative. Most Respondents would not be afraid to be in the same class with a person infected with HIV, live in the same house with a person who is sick or infected and half of the Respondents would not feel a discomfort while working with these people. Only 1/3 of the students allow the possibility of the social contact with a person infected with HIV or a person suffering from AIDS. Most students do not blame people suffering from AIDS for that they contributed to the disease. Conclusions 1. Young people do not have comprehensive knowledge about HIV/AIDS. 2. The Respondents show positive attitudes towards people living with HIV/AIDS and show a willingness to help them; 3. Most students do not blame people suffering from AIDS for that they contributed to the disease

TIAR and FMRP shape pro-survival nascent proteome of leukemia cells in the bone marrow microenvironment

Summary: Chronic myeloid leukemia (CML) cells circulate between blood and bone marrow niche, representing different microenvironments. We studied the role of the two RNA-binding proteins, T-cell-restricted intracellular antigen (TIAR), and the fragile X mental retardation protein (FMRP) in the regulation of protein translation in CML cells residing in settings mimicking peripheral blood microenvironment (PBM) and bone marrow microenvironment (BMM). The outcomes showed how conditions shaped the translation process through TIAR and FMRP activity, considering its relevance in therapy resistance. The QuaNCAT mass-spectrometric approach revealed that TIAR and FMRP have a discrete modulatory effect on protein synthesis and thus affect distinct aspects of leukemic cells functioning in the hypoxic niche. In the BMM setup, FMRP impacted metabolic adaptation of cells and TIAR substantially supported the resistance of CML cells to translation inhibition by homoharringtonine. Overall, our results demonstrated that targeting post-transcriptional control should be considered when designing anti-leukemia therapeutic solutions

Psychosocial difficulties from the perspective of persons with neuropsychiatric disorders

Purpose: The objective of this study is to determine whether persons with neuropsychiatric disorders experience a common set of psychosocial difficulties using qualitative data from focus groups and individual interviews. Method: The study was performed in five European countries (Finland, Italy, Germany, Poland and Spain) using the focus groups and individual interviews with persons with nine neuropsychiatric disorders (dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinsons disease, schizophrenia, stroke and substance dependence). Digitally recorded sessions were analysed using a step-by-step qualitative and quantitative methodology resulting in the compilation of a common set of psychosocial difficulties using the International Classification of Functioning, Disability and Health (ICF) as a framework. Results: Sixty-seven persons participated in the study. Most persons with neuropsychiatric disorders experience difficulties in emotional functions, sleeping, carrying out daily routine, working and interpersonal relationships in common. Sixteen out of 33 psychosocial difficulties made up the common set. This set includes mental functions, pain and issues addressing activities and participation and provides first evidence for the hypothesis of horizontal epidemiology of psychosocial difficulties in neuropsychiatric disorders. Conclusions: This study provides information about psychosocial difficulties that should be covered in the treatment and rehabilitation of persons with neuropsychiatric disorders regardless of clinical diagnoses. Implications for Rehabilitation: Emotional problems, work and sleep problems should be addressed in all the treatments of neuropsychiatric disorders regardless of their specific diagnosis, etiology and severity. Personality issues should be targeted in the treatment for neurological disorders, whereas communication skill training may also be useful for mental disorders. The effects of medication and social environment on patients daily life should be considered in all the neuropsychiatric conditions

PARADISE 24: a measure to assess the impact of brain disorders on people's lives

Objective: To construct a metric of the impact of brain disorders on people's lives, based on the psychosocial difficulties (PSDs) that are experienced in common across brain disorders. Study Design: Psychometric study using data from a cross-sectional study with a convenience sample of 722 persons with 9 different brain disorders interviewed in four European countries: Italy, Poland, Spain and Finland. Questions addressing 64 PSDs were first reduced based on statistical considerations, patient's perspective and clinical expertise. Rasch analyses for polytomous data were also applied. Setting: In and outpatient settings. Results: A valid and reliable metric with 24 items was created. The infit of all questions ranged between 0.7 and 1.3. There were no disordered thresholds. The targeting between item thresholds and persons' abilities was good and the person-separation index was 0.92. Persons' abilities were linearly transformed into a more intuitive scale ranging from zero (no PSDs) to 100 (extreme PSDs). Conclusion: The metric, called PARADISE 24, is based on the hypothesis of horizontal epidemiology, which affirms that people with brain disorders commonly experience PSDs. This metric is a useful tool to carry out cardinal comparisons over time of the magnitude of the psychosocial impact of brain disorders and between persons and groups in clinical practice and research