227 research outputs found
EAPC task force on education for psychologists in palliative care
It is argued that psychological aspects of care and psychosocial problems are essential components of palliative care. However, the provision of appropriate services remains somewhat arbitrary. Unlike medical and nursing care, which are clearly delivered by doctors and nurses respectively, psychological and psychosocial support in palliative care are not assigned exclusively to psychologists. It is generally expected that all professionals working in palliative care should have some knowledge of the psychological dynamics in terminal illness, as well as skills in communication and psychological risk assessment. On the one hand, palliative care education programmes for nurses and doctors comprise a considerable amount of psychological and psychosocial content. On the other hand, only a few palliative care associations provide explicit information on the role and tasks of psychologists in palliative care. Psychologists’ associations do not deal much with this issue either. If they refer to it at all, it is in the context of the care of the aged, end-of-life care or how to deal with grief
Combination therapy with an ACE inhibitor and an angiotensin receptor blocker for diabetic nephropathy: A meta-analysis
Aims: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) prevent the progression of diabetic nephropathy (DN). Studies suggest that combination renin-angiotensin-aldosterone system (RAAS)-inhibiting therapy provides additive benefit in DN. However, these studies are small in size. We performed a meta-analysis of studies investigating combination therapy for DN. Methods: Studies were identified through a search of medline, embase, cinahl and the Cochrane Database. All trials involving combined ACEI and ARB for slowing progression of DN were included. The primary end point was 24-h urinary protein excretion. Blood pressure, serum potassium and glomerular filtration rate (GFR) were secondary end points. Results: In the 10 included trials, 156 patients received ACEI + ARB and 159 received ACEI only. Most studies were 8-12 weeks in duration. Proteinuria was reduced with ACEI + ARB (P = 0.01). This was associated with significant statistical heterogeneity (P = 0.005). ACEI + ARB was associated with a reduction in GFR [3.87 ml/min (7.32-0.42); P = 0.03] and a trend towards an increase in serum creatinine (6.86 μmol/l 95% CI -0.76-13.73; P = 0.09). Potassium was increased by 0.2 (0.08-0.32) mmol/l (P \u3c 0.01) with ACEI + ARB. Systolic and diastolic blood pressure were reduced by 5.2 (2.1-8.4) mmHg (P \u3c 0.01) and 5.3 (2.2-8.4) mmHg (P \u3c 0.01), respectively. Conclusions: This meta-analysis suggests that ACEI + ARB reduces 24-h proteinuria to a greater extent than ACEI alone. This benefit is associated with small effects on GFR, serum creatinine, potassium and blood pressure. These results should be interpreted cautiously as most of the included studies were of short duration and the few long-term studies (12 months) have not demonstrated benefit. © 2007 The Authors
The experience of teasing in elective cosmetic surgery patients
The role of teasing as a motivator for patients undertaking elective cosmetic surgery was investigated. Pre-operative data were collected, using a range of standardized tests in addition to open ended questions about their experience of teasing, from 449 patients aged 18 to 70 undergoing elective cosmetic surgery in Australia. Just under half of the sample indicated that they had been teased or bullied about their appearance. Teased patients showed significantly higher levels of anxiety, depression and dysmorphic concern; lower levels of physical attractiveness and appearance satisfaction; and lower levels of satisfaction with discrete aspects of their appearance than nonteased patients. Teasing also contributed to longer periods of considering surgery as an answer to body dissatisfaction concerns, even when controlling for age. Prevention education initiatives on appearance-related teasing should be targeted at school students. This, along with earlier detection of the psychological impacts of weight and appearance-related teasing, fewer people, if offered strategies for coping through counseling, may contemplate surgery as a response to this teasing
Influence of Residual Gas Composition and Background Pressure in a Multi Stage Co evaporation Chamber on the Quality of Cu In,Ga Se2 Thin Films and Their Device Performance
Combination therapy with an ACE inhibitor and an angiotensin receptor blocker for diabetic nephropathy - a meta-analysis
WSTĘP. Inhibitory konwertazy angiotensyny (ACEI)
i blokery receptora angiotensyny (ARB) zapobiegają
progresji nefropatii cukrzycowej (DN). Wyniki badań
sugerują, że połączenie układu renina-angiotensyna-aldosteron (RAAS) i czynników hamujących działa
addytywnie w procesie leczenia DN. Ponieważ badania
te obejmowały niewielkie grupy chorych, autorzy niniejszej pracy przeprowadzili metaanalizę
prób dotyczących leczenia skojarzonego DN.
METODY. Badania do metaanalizy wybrano na podstawie
baz danych MEDLINE, EMBASE, CINAHL i Cochrane.
Włączono wszystkie próby dotyczące skojarzonego
leczenia za pomocą ACEI i ARB. Głównym
punktem końcowym było dobowe wydalanie białka
z moczem, a dodatkowe punkty końcowe obejmowały: wartości ciśnienia tętniczego, stężenia potasu
we krwi i współczynnika przesączania kłębuszkowego
(GFR).
WYNIKI. W 10 włączonych do analizy badaniach
156 chorych otrzymało ACEI i ARB, a 159 jedynie ACEI. Większość badań trwało 8-12 tygodni. U osób
leczonych ACEI i ARB uzyskano zmniejszenie proteinurii
(p = 0,01), co wiązało się ze znaczną statystyczną heterogenicznością (p = 0,005). Terapia ACEI
i ARB była związana ze zmniejszeniem GFR [3,87 ml/min
(7,32-0,42); p = 0,03] i tendencją do wzrostu stężenia
kreatyniny w surowicy (6,86 umol/l 95% CI -0,76-13,73; p = 0,09). Stężenie potasu zwiększyło się
o 0,2 (0,08-0,32) mmol/l (p < 0,01) u chorych leczonych
ACEI i ARB. Skurczowe i rozkurczowe ciśnienie
krwi obniżyło się odpowiednio o 5,2 mm Hg (2,1-8,4) (p < 0,01) i 5,3 mm Hg (2,2-8,4) (p < 0,01).
WNIOSKI. Wyniki metaanalizy sugerują, że łączne stosowanie
ACEI + ARB w większym stopniu zmniejsza
24-godzinne wydalanie białka z moczem niż przyjmowanie
jedynie ACEI. Korzystne efekty terapii skojarzonej
są wynikiem niewielkiego wpływu leków na
GFR, stężenie kreatyniny i potasu w surowicy oraz
ciśnienie tętnicze. Rezultaty te należy interpretować
ostrożnie, ponieważ większość analizowanych badań charakteryzowała się krótkim czasem obserwacji,
a w kilku długoterminowych próbach (12 miesięcy) nie wykazano korzystnego wpływu leczenia.AIMS. Angiotensin-converting enzyme inhibitors
(ACEIs) and angiotensin receptor blockers (ARBs)
prevent the progression of diabetic nephropathy (DN).
Studies suggest that combination renin-angiotensin-aldosterone system (RAAS)-inhibiting therapy provides
additive benefit in DN. However, these studies
are small in size. We performed a meta-analysis of
studies investigating combination therapy for DN.
METHODS. Studies were identified through a search
of MEDLINE, EMBASE, CINAHL and the Cochrane
Database. All trials involving combined ACEI and ARB
for slowing progression of DN were included. The
primary end point was 24-
Blood pressure, serum potassium and glomerular
filtration rate (GFR) were secondary end points.
RESULTS. In the 10 included trials, 156 patients received
ACEI + ARB and 159 received ACEI only. Most
studies were 8–12 weeks in duration. Proteinuria was
reduced with ACEI + ARB (p = 0.01). This was associated with significant statistical heterogeneity (p = 0.005). ACEI + ARB was associated with a reduction
in GFR [3.87 ml/min (7.32-0.42); p = 0.03] and
a trend towards an increase in serum creatinine (6.86
umol/l 95% CI: -0.76-13.73; p = 0.09). Potassium was
increased by 0.2 (0.08-0.32) mmol/l (p < 0.01) with
ACEI + ARB. Systolic and diastolic blood pressure were
reduced by 5.2 (2.1-8.4) mm Hg (p < 0.01) and 5.3
(2.2-8.4) mm Hg (p < 0.01), respectively.
CONCLUSIONS. This meta-analysis suggests that ACEI +
+ ARB reduces 24-h proteinuria to a greater extent
than ACEI alone. This benefit is associated with small
effects on GFR, serum creatinine, potassium and blood
pressure. These results should be interpreted cautiously
as most of the included studies were of short
duration and the few long-term studies (12 months)
have not demonstrated benefi
S-COL: A Copernican turn for the development of flexibly reusable collaboration scripts
Collaboration scripts are usually implemented as parts of a particular collaborative-learning platform. Therefore, scripts of demonstrated effectiveness are hardly used with learning platforms at other sites, and replication studies are rare. The approach of a platform-independent description language for scripts that allows for easy implementation of the same script on different platforms has not succeeded yet in making the transfer of scripts feasible. We present an alternative solution that treats the problem as a special case of providing support on top of diverse Web pages: In this case, the challenge is to trigger support based on the recognition of a Web page as belonging to a specific type of functionally equivalent pages such as the search query form or the results page of a search engine. The solution suggested has been implemented by means of a tool called S-COL (Scripting for Collaborative Online Learning) and allows for the sustainable development of scripts and scaffolds that can be used with a broad variety of content and platforms. The tool’s functions are described. In order to demonstrate the feasibility and ease of script reuse with S-COL, we describe the flexible re-implementation of a collaboration script for argumentation in S-COL and its adaptation to different learning platforms. To demonstrate that a collaboration script implemented in S-COL can actually foster learning, an empirical study about the effects of a specific script for collaborative online search on learning activities is presented. The further potentials and the limitations of the S-COL approach are discussed
Formation and dynamics of van der Waals molecules in buffer-gas traps
We show that weakly bound He-containing van der Waals molecules can be
produced and magnetically trapped in buffer-gas cooling experiments, and
provide a general model for the formation and dynamics of these molecules. Our
analysis shows that, at typical experimental parameters, thermodynamics favors
the formation of van der Waals complexes composed of a helium atom bound to
most open-shell atoms and molecules, and that complex formation occurs quickly
enough to ensure chemical equilibrium. For molecular pairs composed of a He
atom and an S-state atom, the molecular spin is stable during formation,
dissociation, and collisions, and thus these molecules can be magnetically
trapped. Collisional spin relaxations are too slow to affect trap lifetimes.
However, helium-3-containing complexes can change spin due to adiabatic
crossings between trapped and untrapped Zeeman states, mediated by the
anisotropic hyperfine interaction, causing trap loss. We provide a detailed
model for Ag3He molecules, using ab initio calculation of Ag-He interaction
potentials and spin interactions, quantum scattering theory, and direct Monte
Carlo simulations to describe formation and spin relaxation in this system. The
calculated rate of spin-change agrees quantitatively with experimental
observations, providing indirect evidence for molecular formation in
buffer-gas-cooled magnetic traps.Comment: 20 pages, 13 figure
SARS-CoV-2 T Cell Response in Severe and Fatal COVID-19 in Primary Antibody Deficiency Patients Without Specific Humoral Immunity
Morbidity and mortality of COVID-19 is increased in patients with inborn errors of immunity (IEI). Age and comorbidities and also impaired type I interferon immunity were identified as relevant risk factors. In patients with primary antibody deficiency (PAD) and lack of specific humoral immune response to SARS-CoV-2, clinical disease outcome is very heterogeneous. Despite extensive clinical reports, underlying immunological mechanisms are poorly characterized and levels of T cellular and innate immunity in severe cases remain to be determined. In the present study, we report clinical and immunological findings of 5 PAD patients with severe and fatal COVID-19 and undetectable specific humoral immune response to SARS-CoV-2. Reactive T cells to SARS-CoV-2 spike (S) and nucleocapsid (NCAP) peptide pools were analyzed comparatively by flow cytometry in PAD patients, convalescents and naive healthy individuals. All examined PAD patients developed a robust T cell response. The presence of polyfunctional cytokine producing activated CD4(+) T cells indicates a memory-like phenotype. An analysis of innate immune response revealed elevated CD169 (SIGLEC1) expression on monocytes, a surrogate marker for type I interferon response, and presence of type I interferon autoantibodies was excluded. SARS-CoV-2 RNA was detectable in peripheral blood in three severe COVID-19 patients with PAD. Viral clearance in blood was observed after treatment with COVID-19 convalescent plasma/monoclonal antibody administration. However, prolonged mucosal viral shedding was observed in all patients (median 67 days) with maximum duration of 127 days. PAD patients without specific humoral SARS-CoV-2 immunity may suffer from severe or fatal COVID-19 despite robust T cell and normal innate immune response. Intensified monitoring for long persistence of SARS-CoV-2 viral shedding and (prophylactic) convalescent plasma/specific IgG as beneficial treatment option in severe cases with RNAemia should be considered in seronegative PAD patients
Electrocardiographic profile of guinea pig heart submitted to Ginkgo biloba extract and its terpenoids
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