LESIONS HEPATOBILIAIRES ET MALADIE INFLAMMATOIRE CHRONIQUE DE L'INTESTIN (DES HEPATOLOGIE GASTROENTEROLOGIE)

NANTES-BU Médecine pharmacie (441092101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Autoethnography and mental health nursing

Editoria

Autoethnography and mental health nursing

Editoria

To Hellingly and back: two autoethnographic accounts of life in a mental hospital

This article discusses life in one asylum, Hellingly, near Eastbourne in Sussex. Where once the majority of mental health professionals worked in asylums, their gradual run down and closure saw most staff, as well as patients, transfer into new community services. The two main protagonists in this paper both found themselves at Hellingly Hospital in the 1970s. One was a charge nurse who ran the therapeutic community ward in the hospital. The other was an inmate, who was to begin his alternative mental health career as a ‘revolving door’ patient. Both start by giving their respective memories of the hospital and its impact on their lives. They then reflect on what happened to them after they left the hospital. Now both in their 70s, they have each achieved a sense of contentment with their respective careers in mental health, but via completely different routes. The lessons we can learn from both accounts are drawn out in the discussion section. The fact that the accounts feature a professional and a patient show how far mental health nursing has come over the ensuing 50 years. Patients are partners, and lived experience narratives are indispensable to understand the phenomenology of mental health problems

Enhanced supported living for people with severe and persistent mental health problems: A qualitative investigation

Supported living has been shown to improve functioning and social inclusion in people with severe and persistent mental health problems, reduce hospitalisation and provide secure accommodation in a population where housing needs are often unmet. Conversely, living in supported accommodation has been depicted by some as depersonalising, marginalising and an ordeal to survive. Discussions regarding housing and support often lack a thorough consideration of individual experiences, with a reliance on quantitative surveys. The question remains how to assure that supported accommodations actually are supportive of the residents' ongoing recovery process. The present study sought to shed light on the experiences of residents in an enhanced supported living service in the United Kingdom. Semi‐structured interviews were conducted with nine residents of the service between July 2020 and February 2021. Transcripts were analysed using thematic analysis and indicated three superordinate themes of experiences considered valuable to residents: (1) support from care staff which was readily available; (2), a sense of community and daily activity offered by the residence and on‐site activities; and (3) the experience of supported living as a stepping‐stone in an ongoing recovery process. Findings indicate the power of comprehensive care with supportive staff, peer‐relations, autonomy and fostering hope in empowering individuals in their ongoing recovery

Non-invasive diagnosis and follow-up of autoimmune hepatitis

International audienceAutoimmune hepatitis (AIH) is a liver disease characterised by necrotico-inflammatory lesions of hepatocytes, the presence of specific autoantibodies and response to corticosteroid treatment. AIH must be considered in any patient with acute or chronic liver disease. As there is no pathognomonic sign of AIH, the diagnosis is based on a combination of clinical, biological, immunological and histological findings, after excluding other causes of liver disease. The clinical and biological presentation of AIH is variable and AIH can be associated with an autoimmune biliary disease, primary biliary cholangitis or primary sclerosing cholangitis in an overlap syndrome. For these reasons, diagnosis of AIH can be challenging. Even if liver histology remains essential in the diagnosis of AIH, non-invasive tests can be used at different steps of the management of AIH: diagnosis of AIH, notably diagnosis of an overlap syndrome, assessment of severity of AIH, searching for extra-hepatic disease frequently associated to AIH, evaluation of response to therapy, decision of treatment withdrawal. This review aims to provide practical guidelines for the use of non-invasive tests for the diagnosis and the follow-up of AIH. (C) 2021 Published by Elsevier Masson SAS

Practice guidelines Non-invasive diagnosis and follow-up of primary sclerosing cholangitis

International audiencePrimary sclerosing cholangitis (PSC) is a rare and chronic cholestatic liver disease of unknown cause commonly associated with inflammatory bowel disease (IBD) and characterized by progressive obliterative fibro-inflammation of the biliary tree. Although the natural course is highly variable, PSC is often progressive, leading to biliary cirrhosis and its complications. In addition, PSC is a condition harbouring broad neoplastic potential with increased susceptibility for the development of both biliary and colon cancer. As in other chronic liver diseases, non-invasive methods play a major role in the diagnosis and monitoring of PSC. MR cholangiography is the key exam for the diagnosis and has replaced diagnostic endoscopic retrograde cholangiopancreatography (ERCP). A strict and standardised protocol for carrying out MR cholangiography is recommended. Liver stiffness measured by FibroScan (R) correlates with the degree of liver fibrosis, has a prognostic value and should be repeated during follow-up. Invasive methods still play an important role, especially ERCP which is indicated for therapeutic purposes or for endo-biliary sample collection in suspected cholangiocarcinoma (following discussion in a multidisciplinary team meeting) and total colonoscopy which is recommended at the initial diagnosis of any PSC and annually in patients with IBD. (c) 2021 Elsevier Masson SAS. All rights reserved. .101775 SAS. All rights reserved

Drivers of outcome in compensated alcohol-related cirrhosis: a prospective study

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