High delusional ideation is associated with false pictorial memory

Background and objectives To assess the relationship between false memories and schizotypal experiences in healthy volunteers. Previous research has examined a number of schizotypal dimensions and experiences and found a variety of results. Our aim was to determine the specificity of these associations by giving participants a schizotypy measure which tapped positive, negative and disorganised dimensions (O-LIFE) and another which focused on delusional ideation (PDI). Methods A new memory task was used consisting of images of everyday items, separated into categories. At test participants were presented with pictures which had been seen in the study phase, related lures (additional items from the same categories but which were new) and new items which were not from these categories. Results Positive correlations were found between scores on the positive dimension of schizotypy/delusional ideation and proportion of false memories. Moreover, these participants also had a greater tendency to respond with the highest confidence old response, regardless of the status of the item. No significant correlations were found with the other dimensions of schizotypy. Limitations The confidence finding differs somewhat from previous research, which has found more confidence in memory errors and less confidence in correct responses in schizophrenia. It is unclear the reason(s) for this discrepancy. Conclusions Increased false memory is associated with the positive dimension of schizotypy and delusional ideation and not the disorganised or negative dimensions. Furthermore, our results suggest that those high in positive schizotypy/delusional ideation require less evidence before they are willing to call an item old

EFEKTIFITAS PENGAWASAN DALAM MENINGKATKAN DISIPLIN KERJA APARATUR SIPIL NEGARA DI SEKRETARIAT DAERAH KOTA SORONG

Penelitian ini bertujuan untuk mengetahui Efektifitas Pengawasan terhadap disiplin kerja Pegawai di Sekretariat Daerah Kota Sorong. Salah satu cara untuk mengembangkan ASN dalam sekretariat daerah yaitu dengan jalan meningkatkan pengawasan  di dalam sekretariat daerah dan disiplin kerja di sekretariat daerah tersebut, pengawasan merupakan tenaga penggerak bagi para ASN, dengan adanya pengawasan yang baik, suatu kegiatan sekretariat daerah dapat berjalan lancer, disiplin kerja yang baik dapat menjadi kunci pendorong bagi seorang Pegawai untuk menghasilkan produktivitas. Metode yang digunakan dalam penelitian ini adalah metode deskriptif kualitatif. Berdasarkan hasil penelitian diketahui bahwa pengawasan pada dasarnya diarahkan sepenuhnya untuk menghindari adanya kemungkinan penyelewengan atau penyimpangan atas tujuan yang akan dicapai. Melalui pengawasan diharapkan dapat membantu melaksanakan kebijakan yang telah ditetapkan untuk mencapai tujuan yang telah direncanakan secara efektif dan efisien. Indikator disiplin waktu kerja pada peraturan yang ada (harus ditanamkan dengan baik untuk menumbuhkan rasa tanggung jawab dalam bekerja

Gut microbiota and sirtuins in obesity-related inflammation and bowel dysfunction

Obesity is a chronic disease characterized by persistent low-grade inflammation with alterations in gut motility. Motor abnormalities suggest that obesity has effects on the enteric nervous system (ENS), which controls virtually all gut functions. Recent studies have revealed that the gut microbiota can affect obesity and increase inflammatory tone by modulating mucosal barrier function. Furthermore, the observation that inflammatory conditions influence the excitability of enteric neurons may add to the gut dysfunction in obesity. In this article, we discuss recent advances in understanding the role of gut microbiota and inflammation in the pathogenesis of obesity and obesity-related gastrointestinal dysfunction. The potential contribution of sirtuins in protecting or regulating the circuitry of the ENS under inflamed states is also considered

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

Exploring the impact of ward climate and the development of a tool to measure staff culture in forensic community homes

Background: Secure settings have a distinct environment. They are intended to manage risk whilst balancing a therapeutic approach. This thesis provides an investigation into organisational factors that impact on staff and patient outcomes in secure and community settings; specifically ward climate and staff culture. Ward climate is a multifactorial construct comprised of the material, social and emotional conditions of a ward and the interaction between these. Culture can be summarised as jointly held views, beliefs, and behaviour across a workplace. Staff culture is multidimensional, ranging from broad organisational levels to within-team facets. Research studies evidence the influence of organisational factors on patient rehabilitation and staff burnout. Aims: Healthcare staff in forensic settings experience some of the highest levels of violence compared to other healthcare professionals. Research has evidenced patient violence has significant impact on rehabilitation, other patients, and staff. The first aim of the thesis was to explore published literature of ward climate, focusing on the impact on patient aggression and staff burnout in secure hospitals. There is a paucity of research on organisational factors that can impact rehabilitation in forensic community homes. To enable future research to explore the impact of organisational factors, the thesis aimed to develop a tool that can measure staff culture in community settings. Method: A review of key concepts, definitions and models was first carried out to provide an overview of the thesis and the background for the research (chapter one). It followed by a systematic review that explored the impact ward climate has on two important issues in secure hospitals; patient aggression and staff burnout. Chapter three provides an overview of the methods considered within the development of the tool to measure staff culture. Chapter four explores staff experiences of working in or supporting forensic community homes. Thematic analysis was used to identify themes and sub-themes relating to culture from interviews undertaken with members of a multidisciplinary team. Findings were used to inform the development of the Cultural Assessment of Staff Teams (CAST), a psychometric tool measuring staff culture. Chapter five describes further development and validation of the CAST tool. It outlines the processes to ascertain face and content validity of items. Item reduction and re-wording were completed following the scoring of the expert feedback. Following cognitive interviews with a sample of the target population (support workers) final amendments were made to the tool. Results: The thesis contributes to the research regarding organisational factors in forensic settings. The systematic review found mixed results. There was an overall finding that the higher the security of the ward the greater the impact ward climate had on patient aggression. Staff burnout and sickness were associated with ward climate. Regarding the tool development, the domains identified to measure staff culture in community settings were ’The Organisation‘, ’Home Manager‘, ’Care Team‘, and ’Risk Management‘. The first version of the tool had 129 items. Once the face and content validity were scored and cognitive interviews were facilitated, the numbers of items decreased to 86. Discussion: This thesis emphasises the importance of forensic settings measuring and responding to organisational factors. The thesis provides an insight into the concepts of staff culture in forensic community homes and has informed the development of the CAST. Compared to inpatient settings there is a lack of published work on the impact of organisational factors in forensic community settings. The CAST will enable further research to be undertaken to identify relationships between staff culture and resident outcome