Theodicy and End-of-Life Care

Acknowledgments The section on Islamic perspective is contributed by information provided by Imranali Panjwani, Tutor in Theology & Religious Studies, King's College London.Peer reviewedPublisher PD

The Impact of Job Stability, Work Environment, Administration, Salary and Incentives, Functional Justice, and Employee Expectation on the Security Staff’s Desire to Continue Working at the Hotel

Hotels guests and employees have acquired a huge number of studies and research, while the security department staff, who are responsible for the hotels security and customers, did not get the researchers attention. Therefore, the study is conducted to highlight an important section in the hospitality industry that has been neglected. The quantitative approach was utilized to explore the impact of Job Stability, Work Environment, Hotel Administration, Salary and Incentives, Functional Justice, and Employee Expectation on the security staff’s Desire to Continue Working at the hotel. An online questionnaire is designed and sent to the directors of the security department of the hotels. Results revealed that Hotel Administration, Functional Justice, and Employee Expectations impact their desire to continue working at the hotel. The study has contributed theoretically to fill this gap in the literature caused by the scarcity of studies that targeted the work health of the security department staff. The study also contains many practical aspects that help hotel management pay great attention to the hotel security department

Prevalence of psychosis in black ethnic minorities in Britain: analysis based on three national surveys

Purpose A considerable excess of psychosis in black ethnic minorities is apparent from clinical studies, in Britain, as in other developed economies with white majority populations. This excess is not so marked in population surveys. Equitable health service provision should be informed by the best estimates of the excess. We used national survey data to establish the difference in the prevalence of psychosis between black ethnic groups and the white majority in the British general population. Methods Analysis of the combined datasets (N = 26,091) from the British national mental health surveys of 1993, 2000 and 2007. Cases of psychosis were determined either by the use of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), or from a combination of screening items. We controlled for sex, age, social class, unemployment, design features and other putative confounders, using a Disease Risk Score. Results People from black ethnic minorities had an excess prevalence rate of psychosis compared with the white majority population. The OR, weighted for study design and response rate, was 2.72 (95 % CI 1.3–5.6, p = 0.002). This was marginally increased after controlling for potential confounders (OR = 2.90, 95 % CI 1.4–6.2, p = 0.006). Conclusions The excess of psychosis in black ethnic minority groups was similar to that in two previous British community surveys, and less than that based on clinical studies. Even so it confirms a considerable need for increased mental health service resources in areas with high proportions of black ethnic minority inhabitants

Policies on sexual expression in forensic psychiatric settings in different European countries

Background: Sexual expression by forensic psychiatric patients is poorly researched. Methods: Forensic experts representing 14 European countries were interviewed to explore the diverse ways in which sexual expression within forensic settings is handled. Results: No country had a national policy, although many had local policies or shared practices. Progressive approaches to patient sexuality were evident in nine of the countries sampled. The UK appeared the most prohibiting and excluding, its protocols apparently based on risk aversion and lack of emphasis or consideration of patients’ sexual needs. Conclusions: Uniform national policy supporting patients’ sexual expression would provide significant improvements

Impact of perioperative chemotherapy on survival in patients with advanced primary urethral cancer: results of the international collaboration on primary urethral carcinoma

This is the first series that suggests a prognostic benefit of neoadjuvant treatment in a consecutive series of patients who underwent perioperative chemotherapy plus surgery for advanced primary urethral carcinoma. Further studies should yield a better understanding of how perioperative chemotherapy exerts a positive effect on survival in order to selectively advocate its use in advanced primary urethral carcinom

The relationship between the systemic inflammatory response and survival in patients with transitional cell carcinoma of the urinary bladder

The relationship between tumour stage, grade, elevated C-reactive protein concentration (<10/>10 mg l−1), adjuvant therapy and survival was examined in patients with biopsy proven bladder cancer (n=105). On multivariate analysis stage (HR 3.37, 95% CI 1.37–8.29, P=0.008), grade (HR 2.01, 95% CI 1.14–3.57, P=0.017) and preoperative C-reactive protein (HR 3.31, 95% CI 1.09–10.09, P=0.035) were independently associated with cancer-specific survival

Moving Beyond Christianity: Islam, Judaism, Hinduism and Mental Health

To date the literature on religion and mental health has focused upon Christianity. We cannot assume that these findings can be transposed onto other faith groups. In this paper I focus upon Islam, Judaism and Hinduism and discuss understandings of mental illness and the relationships between central beliefs and mental health. I discuss implications for clinical work and psychotherapy

Fluorescence in-situ hybridisation on biopsies from clam ileocystoplasties and on a clam cancer

The incidence of carcinoma following an enterocystoplasty increases with time and is a major concern after such procedures. The aim of this study was to investigate genetic instability (in the form of numerical chromosomal aberrations) at the enterovesical anastomosis in patients who had undergone a clam ileocystoplasty using fluorescent in-situ hybridisation (FISH). Fluorescent in-situ hybridisation was performed on touch preparation samples prepared from fresh endoscopic biopsies obtained from the enterovesical anastomosis and native bladder remnant (control specimens) of 15 patients who had undergone a clam ileocystoplasty. Fluorescent in-situ hybridisation was also performed on one squamous cell cancer specimen. Significant aneusomic changes were found at the enterovesical anastomosis in all 15 patients. Alterations in chromosome 18 copy number were the most frequent abnormal finding (trisomy 18, n=8; monosomy 18, n=7). Nine patients were monosomic for chromosome 9. Isolated monosomy 8 and trisomy 8 were each found in one patient. The control specimens were all normal. An unusually high incidence of polysomic cells was found in the clam tumour specimen, reflecting the aggressive nature of this cancer. Chromosomal numerical abnormalities occur at the enterovesical anastomosis following a clam ileocystoplasty and chromosome 18 appears to be a particularly good marker of genetic instability. The results of this study indicate that morphologically normal tissue obtained from the enterovesical anastomosis displays evidence of chromosomal instability that may predispose to tumour formation. However, further prospective, blinded, longitudinal studies are required to establish whether predetermined FISH signal patterns in enterocystoplasty cells in urine or obtained by biopsy predict the presence or absence of tumour

Bicultural identity among economical migrants from three south European countries living in Switzerland. Adaptation and validation of a new psychometric instrument

<p>Abstract</p> <p>Background</p> <p>Acculturation is one of the determinants of mental health among immigrants. Evaluating adaptation to the host culture is insufficient, since immigrants will develop various degrees of bi- or multicultural identity. However, mental health professionals lack simple and easy to use instruments to guide them with bicultural identity evaluation in their practice. Our aim was to develop such an instrument to be used for clinical purposes among economical migrants from three South European countries living in Geneva, Switzerland.</p> <p>Methods</p> <p>We adapted from existing instruments a 24 item bi-dimensional scale to assess involvement in both culture of origin and host culture. The study included 93 immigrant adults from three south European countries (Italy, Portugal and Spain). Thirty-eight patients were recruited in an outpatient treatment program for alcohol-related problems and 55 participants were hospital employees.</p> <p>Results</p> <p>The questionnaire was rated as easy or rather easy by 97.8% of participants. Median time to complete it was 5 minutes. The instrument allowed discriminating between patients and healthy subjects, with scores for Swiss culture significantly higher among hospital workers. The subscales related to culture of origin and host culture displayed adequate internal consistency (Cronbach's alpha 0.77 and 0.73 respectively).</p> <p>Conclusion</p> <p>It is possible to assist clinicians' assessment of cultural identity of Italian, Portuguese and Spanish economical immigrants in Switzerland with a single and easy to use instrument.</p

Awareness of cancer symptoms and anticipated help seeking among ethnic minority groups in England

&lt;p&gt;Objective: Little is known about ethnic differences in awareness of cancer-warning signs or help-seeking behaviour in Britain. As part of the National Awareness and Early Diagnosis Initiative (NAEDI), this study aimed to explore these factors as possible contributors to delay in cancer diagnosis.&lt;/p&gt; &lt;p&gt;Methods: We used quota sampling to recruit 1500 men and women from the six largest minority ethnic groups in England (Indian, Pakistani, Bangladeshi, Caribbean, African and Chinese). In face-to-face interviews, participants completed the newly developed cancer awareness measure (CAM), which includes questions about warning signs for cancer, speed of consultation for possible cancer symptoms and barriers to help seeking.&lt;/p&gt; &lt;p&gt;Results: Awareness of warning signs was low across all ethnic groups, especially using the open-ended (recall) question format, with lowest awareness in the African group. Women identified more emotional barriers and men more practical barriers to help seeking, with considerable ethnic variation. Anticipated delay in help seeking was higher in individuals who identified fewer warning signs and more barriers.&lt;/p&gt; &lt;p&gt;Conclusions: The study suggests the need for culturally sensitive, community-based interventions to raise awareness and encourage early presentation.&lt;/p&gt