Mindfulness in informal caregivers of palliative patients

AbstractObjectives:Mindfulness is a concept of growing impact on psychotherapy and has been shown to be effective for stress reduction and to improve psychological well-being. Existential Behavioural Therapy (EBT) was developed to support relatives of palliative care (PC) patients to cope with their situation during caregiving and bereavement. Mindfulness training was a core element of the intervention.We investigated the relationship between mindfulness, mental distress, and psychological well-being in informal caregivers, and evaluated if the effects of the intervention were mediated by mindfulness.Methods:Relatives of PC inpatients took part in a randomized-controlled EBT trial and completed the Cognitive and Affective Mindfulness Scale-Revised, items from the Five Facets of Mindfulness as well as the Brief Symptom Inventory, the Satisfaction with Life Scale, the WHOQOL-BREF, a numerical rating scale on quality of life (range 0–10), and the Schedule for Meaning in Life Evaluation at pre- and post-intervention, and a 3- and 12-months follow-up.Results:One-hundred-and-thirty carers were included, most of them (71.6%) recently being bereaved at the beginning of the intervention. High correlations between mindfulness and mental distress (r = −0.51, p &lt; 0.001) as well as life satisfaction (r = 0.52, p &lt; 0.001) were found. Mindfulness was a significant predictor of improvement in psychological distress, meaning in life and quality of life three months after the intervention. The EBT effects were partly mediated by mindfulness.Significance of results:Mindfulness seems to be a promising concept in supporting informal caregivers of PC patients. Further research is needed to identify the required format and intensity of mindfulness practice necessary for improvement.</jats:sec

Improved production of human type II procollagen in the yeast Pichia pastoris in shake flasks by a wireless-controlled fed-batch system

<p>Abstract</p> <p>Background</p> <p>Here we describe a new technical solution for optimization of <it>Pichia pastoris </it>shake flask cultures with the example of production of stable human type II collagen. Production of recombinant proteins in <it>P. pastoris </it>is usually performed by controlling gene expression with the strong AOX1 promoter, which is induced by addition of methanol. Optimization of processes using the AOX1 promoter in <it>P. pastoris </it>is generally done in bioreactors by fed-batch fermentation with a controlled continuous addition of methanol for avoiding methanol toxification and carbon/energy starvation. The development of feeding protocols and the study of AOX1-controlled recombinant protein production have been largely made in shake flasks, although shake flasks have very limited possibilities for measurement and control.</p> <p>Results</p> <p>By applying on-line pO₂monitoring we demonstrate that the widely used pulse feeding of methanol results in long phases of methanol exhaustion and consequently low expression of AOX1 controlled genes. Furthermore, we provide a solution to apply the fed-batch strategy in shake flasks. The presented solution applies a wireless feeding unit which can be flexibly positioned and allows the use of computer-controlled feeding profiles.</p> <p>By using the human collagen II as an example we show that a quasi-continuous feeding profile, being the simplest way of a fed-batch fermentation, results in a higher production level of human collagen II. Moreover, the product has a higher proteolytic stability compared to control cultures due to the increased expression of human collagen prolyl 4-hydroxylase as monitored by mRNA and protein levels.</p> <p>Conclusion</p> <p>The recommended standard protocol for methanol addition in shake flasks using pulse feeding is non-optimal and leads to repeated long phases of methanol starvation. The problem can be solved by applying the fed-batch technology. The presented wireless feeding unit, together with an on-line monitoring system offers a flexible, simple, and low-cost solution for initial optimization of the production in shake flasks which can be performed in parallel. By this way the fed-batch strategy can be applied from the early screening steps also in laboratories which do not have access to high-cost and complicated bioreactor systems.</p

Meaning in Life in Patients With Progressive Supranuclear Palsy

Background: Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are characterized by rapid deterioration and a fatal outcome. Objectives: Admission triggers, treatment efficacy, and care patterns. Methods: Retrospective analysis of patients with PSP/CBD admitted to an inpatient specialized palliative care service. Results: In 38 patients, there were 63 admissions for swallowing difficulties, falls, pain, impaired communication, cognitive/mood disturbances, respiratory symptoms, and infection. Mean length of stay was 11.6 days. Treatment response was variable. In 68%, of admission episodes there was stabilization or improvement, 75% were discharged home. In case of readmission, the mean interval has been 9.7 months. Time since diagnosis and admission triggers were not associated with outcome or death. Conclusion: Patients showed high symptom load contrasting with discharge rates and subsequent health care utilization. Brief multidisciplinary interventions might be helpful to preserve autonomy

Mindfulness in informal caregivers of palliative patients

Abstract Objectives: Mindfulness is a concept of growing impact on psychotherapy and has been shown to be effective for stress reduction and to improve psychological well-being. Existential Behavioural Therapy (EBT) was developed to support relatives of palliative care (PC) patients to cope with their situation during caregiving and bereavement. Mindfulness training was a core element of the intervention. We investigated the relationship between mindfulness, mental distress, and psychological well-being in informal caregivers, and evaluated if the effects of the intervention were mediated by mindfulness. Methods: Relatives of PC inpatients took part in a randomized-controlled EBT trial and completed the Cognitive and Affective Mindfulness Scale-Revised, items from the Five Facets of Mindfulness as well as the Brief Symptom Inventory, the Satisfaction with Life Scale, the WHOQOL-BREF, a numerical rating scale on quality of life (range 0-10), and the Schedule for Meaning in Life Evaluation at pre- and post-intervention, and a 3- and 12-months follow-up. Results: One-hundred-and-thirty carers were included, most of them (71.6%) recently being bereaved at the beginning of the intervention. High correlations between mindfulness and mental distress (r=−0.51, p<0.001) as well as life satisfaction (r=0.52, p<0.001) were found. Mindfulness was a significant predictor of improvement in psychological distress, meaning in life and quality of life three months after the intervention. The EBT effects were partly mediated by mindfulness. Significance of results: Mindfulness seems to be a promising concept in supporting informal caregivers of PC patients. Further research is needed to identify the required format and intensity of mindfulness practice necessary for improvemen

Cultivation in shake flasks with methanol feeding without (A, B) or with (C, D) manual pH adjustment

Cultivations were performed in two phases: initial batch phase in BMG-medium and fed-batch in BMM-medium. Dissolved oxygen (pO) and pH were measured with a wireless measuring system, cell growth was followed by measurement of the OD. Vertical lines represent methanol feeding points in A and C or start of methanol feed in B and D.<p><b>Copyright information:</b></p><p>Taken from "Improved production of human type II procollagen in the yeast in shake flasks by a wireless-controlled fed-batch system"</p><p>http://www.biomedcentral.com/1472-6750/8/33</p><p>BMC Biotechnology 2008;8():33-33.</p><p>Published online 27 Mar 2008</p><p>PMCID:PMC2315644.</p><p></p

Growth parameters (A) and concentrations of product-related mRNA species (B) during cultivation of a for production of recombinant human collagen II in shake flasks

Cultivation procedures with two methanol pulses per day (control, blue open circles, interrupted blue line) and pO-dependent manual feeding of methanol (red filled circles, red continuous line) were compared.<p><b>Copyright information:</b></p><p>Taken from "Improved production of human type II procollagen in the yeast in shake flasks by a wireless-controlled fed-batch system"</p><p>http://www.biomedcentral.com/1472-6750/8/33</p><p>BMC Biotechnology 2008;8():33-33.</p><p>Published online 27 Mar 2008</p><p>PMCID:PMC2315644.</p><p></p

Schematic presentation of the wireless data collection and control system for shake flask cultivations

<p><b>Copyright information:</b></p><p>Taken from "Improved production of human type II procollagen in the yeast in shake flasks by a wireless-controlled fed-batch system"</p><p>http://www.biomedcentral.com/1472-6750/8/33</p><p>BMC Biotechnology 2008;8():33-33.</p><p>Published online 27 Mar 2008</p><p>PMCID:PMC2315644.</p><p></p