Monitoring the impact of the DRG payment system on nursing service context factors in Swiss acute care hospitals : study protocol

With this study protocol, a research program is introduced. Its overall aim is to prepare the instruments and to conduct the first monitoring of nursing service context factors at three university and two cantonal hospitals in Switzerland prior to the introduction of the reimbursement system based on Diagnosis Related Groups (DRG) and to further develop a theoretical model as well as a methodology for future monitoring following the introduction of DRGs.Mit diesem Studienprotokoll wird ein Forschungsprogramm eingeführt. Dessen Ziel ist das Vorbereiten der Instrumente und das Durchführen des ersten Monitorings von Pflegekontextfaktoren an drei Universitäts- und zwei Kantonsspitälern in der Schweiz noch vor Einführung der DRG-basierten Finanzierung, sowie darauf aufbauend das Weiterentwickeln des theoretischen Modells und der dazu gehörenden Methodologie für zukünftige Monitorings nach Einführung der DRGs

Sanierung Stauanlagen im Zürcher Oberland

Aufsatz veröffentlicht in: "Wasserbau-Symposium 2021: Wasserbau in Zeiten von Energiewende, Gewässerschutz und Klimawandel, Zurich, Switzerland, September 15-17, 2021, Band 1" veröffentlicht unter: https://doi.org/10.3929/ethz-b-00049975

Mapping genomic loci implicates genes and synaptic biology in schizophrenia

Schizophrenia has a heritability of 60-80%1, much of which is attributable to common risk alleles. Here, in a two-stage genome-wide association study of up to 76,755 individuals with schizophrenia and 243,649 control individuals, we report common variant associations at 287 distinct genomic loci. Associations were concentrated in genes that are expressed in excitatory and inhibitory neurons of the central nervous system, but not in other tissues or cell types. Using fine-mapping and functional genomic data, we identify 120 genes (106 protein-coding) that are likely to underpin associations at some of these loci, including 16 genes with credible causal non-synonymous or untranslated region variation. We also implicate fundamental processes related to neuronal function, including synaptic organization, differentiation and transmission. Fine-mapped candidates were enriched for genes associated with rare disruptive coding variants in people with schizophrenia, including the glutamate receptor subunit GRIN2A and transcription factor SP4, and were also enriched for genes implicated by such variants in neurodevelopmental disorders. We identify biological processes relevant to schizophrenia pathophysiology; show convergence of common and rare variant associations in schizophrenia and neurodevelopmental disorders; and provide a resource of prioritized genes and variants to advance mechanistic studies

Mapping genomic loci prioritises genes and implicates synaptic biology in schizophrenia

Schizophrenia has a heritability of 60–80%1, much of which is attributable to common risk alleles. Here, in a two-stage genome-wide association study of up to 76,755 individuals with schizophrenia and 243,649 control individuals, we report common variant associations at 287 distinct genomic loci. Associations were concentrated in genes that are expressed in excitatory and inhibitory neurons of the central nervous system, but not in other tissues or cell types. Using fine-mapping and functional genomic data, we identify 120 genes (106 protein-coding) that are likely to underpin associations at some of these loci, including 16 genes with credible causal non-synonymous or untranslated region variation. We also implicate fundamental processes related to neuronal function, including synaptic organization, differentiation and transmission. Fine-mapped candidates were enriched for genes associated with rare disruptive coding variants in people with schizophrenia, including the glutamate receptor subunit GRIN2A and transcription factor SP4, and were also enriched for genes implicated by such variants in neurodevelopmental disorders. We identify biological processes relevant to schizophrenia pathophysiology; show convergence of common and rare variant associations in schizophrenia and neurodevelopmental disorders; and provide a resource of prioritized genes and variants to advance mechanistic studies

Which client characteristics contribute to good and poor cognitive-behavioural treatment outcome for social anxiety disorder? A survey of clinicians

The aim of the study was to survey a group of clinicians who identify themselves as experienced in treating social anxiety disorder using cognitive behavioural treatment (CBT) with regard to the characteristics of clients which they think, based on their experience, are predictive of poor or good CBT outcome. Fifty-four practising clinicians responded to an email inviting participation in a research study of clinicians' opinions about client characteristics that may be important in CBT outcome for social anxiety. Participants completed open-ended questions about, and made ratings of the importance of, client characteristics that they believed impact upon the outcome of CBT for social anxiety disorder. Motivation for seeking treatment, comorbidity, and intellect or reasoning ability were nominated most frequently by clinicians as having an effect on CBT outcome. Acceptance of the CBT rationale/model, ability to take responsibility for change, motivation/reason for seeking treatment, and ability to develop an alliance were all rated by participants as being important in contributing to CBT outcome. The results provide direction for future empirical research on client characteristics as predictors of CBT outcome.8 page(s

The role of dispositional mindfulness in affective and physiological reactivity across the adult lifespan

Thesis by publication."Centre for Emotional Health, Department of Psychology, Faculty of Human Sciences, Macquarie University" -- title page.Includes bibliographical references.Chapter One. General introduction -- Chapter Two. Study One. The role of dispositional mindfulness in affective and physiological reactivity across the adult lifespan : a systematic review -- Chapter Three. Study Two. Affective and physiological reactivity across adulthood : the role of dispositional mindfulness -- Chapter Four. General discussion.Ageing is associated with a number of changes, including an increase in positive affect (Stawski, Sliwinski, Almeida, & Smyth, 2008), reduction in negative affect (Kessler & Staudinger, 2009), and overall enhanced emotion regulation (Gross et al., 1997). One factor that may contribute to these age-related changes is mindfulness, defined as an awareness of and attention to the present moment (Brown & Ryan, 2003). The first paper reviewed the literature regarding dispositional mindfulness, and affective and physiological reactivity across the adult lifespan, and identified a paucity of relevant studies. The second paper investigated the role of dispositional mindfulness on physiological and affect reactivity, using a sample of younger, middle-aged and older adults who completed two mood-induction tasks. A significant correlation was found between dispositional mindfulness and age. Furthermore, older adults reported higher levels of positive affect, and lower levels of negative affect and perceived stress, compared to middle-aged and younger adults. No significant differences were identified in physiological reactivity by age. Finally, dispositional mindfulness was found to be related to positive affect. The findings from the present thesis will contribute to our knowledge of the relationship between dispositional mindfulness, affective and physiological reactivity, and ageing.Mode of access: World wide web1 online resource (x, 169 pages) graphs, table

Barriers to treatment for older adults seeking psychological therapy

BACKGROUND: Older adults with mental health disorders underutilize mental health services more than other adults. While there are well known general barriers to help seeking across the population, specific barriers for older adults include difficulties with transportation, beliefs that it is normal to be anxious and depressed in old age, and beliefs by referrers that psychological therapy is less likely to be effective. This study examined barriers related to identifying the need for help, seeking help and participating in therapy in a clinical population of older adults. METHOD: Sixty older adults (aged 60-79 years) with comorbid anxiety and unipolar mood disorders completed barriers to treatment questionnaires before and after psychological group treatment, as well as measures of cognitive ability, anxiety, depression, and quality of life at baseline. RESULTS: The greatest barriers to help seeking related to difficulties identifying the need for help, with 50% of the sample reporting their belief that their symptoms were normal as a major barrier. Other major barriers identified were related to: self-reliance, cost of treatment, and fear of medication replicating previous findings. The main barriers reported for difficulties in continuing therapy included not finding therapy helpful, cost of treatment, and thinking that the therapist did not understand their issues. CONCLUSIONS: The main barriers identified related to issues with identifying the need to seek help. More attention is needed to educate older adults and professionals about the need for, and effectiveness of, psychological therapies for older adults with anxiety and depression to reduce this barrier to help seeking.10 page(s