The TeleTAnDem intervention - Study protocol for a psychotherapeutic intervention for family caregivers of people with dementia

Soellner R, Reder M, Machmer A, Holle R, Wilz G. The TeleTAnDem intervention - Study protocol for a psychotherapeutic intervention for family caregivers of people with dementia. BMC Nursing. 2015;14(11): 11

Long-term life changes and stress sequelae for spouses of stroke patients

Objective: This study investigates the long-term effect of stroke on the quality of life and health of patients’ spouses. Method: Twenty-six spouses of stroke patients were interviewed by means of standardized questionnaires and qualitative interviews. The study participants had been living with the consequences of stroke for 3 years on average when the interviews were carried out. Results: A stroke is often followed by considerable changes in everyday life and by role shifts within the relationship. In particular, depressive and aggressive changes in the patient’s behaviour are experienced as burdensome. In addition to impairments in quality of life, psychological and psychosomatic troubles can also from the burden experienced. Depressive symptoms are the main factor in these negative consequences: the more a patient is assessed as depressive, the more his/her spouse reports health problems and poor quality of life. Discussion: Long-term changes in everyday life and partnership can bring about significant chronic burden for the spouses of stroke patients. Hence, offers of support and counseling are required not only in the acute and post-acute stages of stroke, but also after inpatient rehabilitation has ended

Pyelonephritis in slaughter pigs and sows: Morphological characterization and aspects of pathogenesis and aetiology

<p>Abstract</p> <p>Background</p> <p>Pyelonephritis is a serious disease in pig production that needs to be further studied. The purpose of this study was to describe the morphology, investigate the pathogenesis, and evaluate the aetiological role of <it>Escherichia coli </it>in pyelonephritis in slaughtered pigs by concurrent bacteriological, gross and histopathological examinations.</p> <p>Methods</p> <p>From Danish abattoirs, kidneys and corresponding lymph nodes from 22 slaughtered finishing pigs and 26 slaughtered sows with pyelonephritis were collected and evaluated by bacteriology and pathology. Based on gross lesions, each kidney (lesion) was grouped as acute, chronic, chronic active, or normal and their histological inflammatory stage was determined as normal (0), acute (1), sub-acute (2), chronic active (3), or chronic (4). Immunohistochemical identification of neutrophils, macrophages, T-lymphocytes, B-lymphocytes, plasma cells, <it>E. coli </it>and Tamm-Horsfall protein (THP) in renal sections was performed. The number of <it>E. coli </it>and the proportion of immunohistochemically visualized leukocytes out of the total number of infiltrating leukocytes were scored semi-quantitatively.</p> <p>Results</p> <p>Lesions in finishing pigs and sows were similar. Macroscopically, multiple unevenly distributed foci of inflammation mostly affecting the renal poles were observed. Histologically, tubulointerstitial infiltration with neutrophils and mononuclear cells and tubular destruction was the main findings. The significant highest scores of L1 antigen⁺neutrophils were in inflammatory stage 1 while the significant highest scores of CD79αcy⁺B-lymphocytes, IgG⁺and IgA⁺plasma cells were in stage 3 or 4. Neutrophils were the dominant leukocytes in stage 1 while CD3ε⁺T-lymphocytes dominated in stage 2, 3 and 4. Interstitially THP was seen in 82% and 98% of kidneys with pyelonephritis from finishing pigs and sows, respectively. <it>E. coli </it>was demonstrated in monoculture and/or identified by immunohistochemistry in relation to inflammation in four kidneys from finishing pigs and in 34 kidneys from sows.</p> <p>Conclusions</p> <p><it>E. coli </it>played a significant role in the aetiology of pyelonephritis. Neutrophils were involved in the first line of defence. CD3ε⁺T-lymphocytes were involved in both the acute and chronic inflammatory response while a humoral immune response was most pronounced in later inflammatory stages. The observed renal lesions correspond with an ascending bacterial infection with presence of intra-renal reflux.</p

Confusion and dependence in uses of history

Many people argue that history makes a special difference to the subjects of biology and psychology, and that history does not make this special difference to other parts of the world. This paper will show that historical properties make no more or less of a difference to biology or psychology than to chemistry, physics, or other sciences. Although historical properties indeed make a certain kind of difference to biology and psychology, this paper will show that historical properties make the same kind of difference to geology, sociology, astronomy, and other sciences. Similarly, many people argue that nonhistorical properties make a special difference to the nonbiological and the nonpsychological world. This paper will show that nonhistorical properties make the same difference to all things in the world when it comes to their causal behavior and that historical properties make the same difference to all things in the world when it comes to their distributions. Although history is special, it is special in the same way to all parts of the worl

Psychische Belastungen bei Angehörigen von Schlaganfallpatienten

Sustained psychosocial burdens as a consequence of stroke not only affect the stroke victim but frequently their spouses and significant others as well. The present study analyses the extent of emotional burden in spouses of stroke patients (Beck Depression Inventory, BDI and Beck Anxiety Inventory, BAI), examining the relationships of emotional burden in spouses with the medical assessment regarding stroke severity (Barthel Index, BI) and with the spouses' own perceptions of the stroke patients' impairment (Patient Competency Rating, PCR) as well as determining the factors that were independently associated with emotional burden in spouses. 82 spouses of stroke patients are examined in our study. The questioning was realised on admission into inpatient or partially inpatient rehabilitation centres. Initial results indicated that relatives of stroke victims have higher scores for anxiety compared to the general population. The assessment of disability in the stroke victims by their spouses correlates directly with the psychosocial burden of the spouses. By using this methodology, a high-risk group of spouses could be identified. The predictors of emotional burden in spouses (Anxiety and Depression) are gender of spouse and the spouse's subjective perception of disability in the stroke victim. The age of spouses and medical assessment of the severity of stroke on the other hand have no predictive value for the extent of emotional burden in spouses

"Ich hoffe, dass es wieder wird wie vorher...": Prospektive Annahmen von Patienten und Angehörigen über die Folgen des Schlaganfalls zu Beginn der Rehabilitation

In der vorliegenden Arbeit werden die Annahmen untersucht, die Patienten und Angehörige zu Beginn der Rehabilitation über die Folgen des Schlaganfalls entwickeln. Es wird erwartet, dass diese Annahmen das Krankheitserleben und die subjektive Lebensqualität der Befragten beeinflussen. Die Frage nach Inhalt und Funktionalität krankheitsbezogener Kognitionen führt in das Forschungsgebiet subjektiver Krankheitstheorien, auf dem für cerebrovaskuläre Erkrankungen bisher nur wenige Ergebnisse vorliegen. Die Untersuchungsstichprobe besteht aus 92 Personen, jeweils 46 Schlaganfallpatienten und deren Lebenspartner. Die Datenerhebung erfolgte unmittelbar nach Aufnahme in die Rehabilitationseinrichtung. Die subjektiv-theoretischen Annahmen über die Krankheitsfolgen wurden mittels eines halb-strukturierten Interviews erhoben. Das Krankheitserleben wurde über eine Einschätzung der subjektiven Beeinträchtigung durch den Schlaganfall mittels des Patient Competency Rating (Prigatano, 1986) und die subjektive Lebensqualität mittels des WHOQOL-BREF (Angermeyer, Kilian & Matschinger, 2000) erfasst. Im Zentrum des "vorwärts gerichteten" subjektiven Theoretisierens (Filipp, 1990) über die Krankheitsfolgen stehen sowohl bei den Patienten als auch bei den Angehörigen die Auswirkungen des Schlaganfalls auf die zukünftige Bewältigung des Alltags und die Gesundheit. Daneben ist die Mehrzahl der Befragten davon überzeugt, die Folgen des Schlaganfalls durch eigenes Bemühen, Willenskraft und engagierte Mitarbeit in den Therapien günstig beeinflussen zu können. Es zeigt sich, dass die Wahrnehmung subjektiver Kontrolle über die Erkrankung - unabhängig von den tatsächlichen funktionellen Beeinträchtigungen - sowohl bei den Patienten als auch bei den Angehörigen mit einer besseren Einschätzung des gesundheitlichen Status sowie mit einer höheren Lebensqualität einhergeht