Shared decision-making for psychiatric medication : A mixed-methods evaluation of a UK training programme for service users and clinicians

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).Background: Shared decision making (SDM) is recognised as a promising strategy to enhance good collaboration between clinicians and service users, yet it is not practised regularly in mental health. Aims: Develop and evaluate a novel training programme to enhance SDM in psychiatric medication management for service users, psychiatrists and care co-ordinators. Methods: The training programme design was informed by existing literature and local stakeholders consultations. Parallel group-based training programmes on SDM process were delivered to community mental health service users and providers. Evaluation consisted of quantitative measures at baseline and 12-month follow-up, post-programme participant feedback and qualitative interviews. Results: Training was provided to 47 service users, 35 care-coordinators and 12 psychiatrists. Participant feedback was generally positive. Statistically significant changes in service users’ decisional conflict and perceptions of practitioners’ interactional style in promoting SDM occurred at the follow-up. Qualitative data suggested positive impacts on service users’ and care co-ordinators confidence to explore medication experience, and group-based training was valued. Conclusions: The programme was generally acceptable to service users and practitioners. This indicates the value of conducting a larger study and exploring application for non-medical decisions.Peer reviewedFinal Published versio

Precise measurement of RudsR_{\text{uds}} and RR between 1.84 and 3.72 GeV at the KEDR detector

The present work continues a series of the KEDR measurements of the $R$ value that started in 2010 at the VEPP-4M $e^+e^-$ collider. By combining new data with our previous results in this energy range we measured the values of $R_{\text{uds}}$ and $R$ at nine center-of-mass energies between 3.08 and 3.72 GeV. The total accuracy is about or better than $2.6\%$ at most of energy points with a systematic uncertainty of about $1.9\%$. Together with the previous precise $R$ measurement at KEDR in the energy range 1.84-3.05 GeV, it constitutes the most detailed high-precision $R$ measurement near the charmonium production threshold.Comment: arXiv admin note: text overlap with arXiv:1610.02827 and substantial text overlap with arXiv:1510.0266

МУТАЦИИ МИКОБАКТЕРИИ ТУБЕРКУЛЕЗА, ОБУСЛОВЛИВАЮЩИЕ УСТОЙЧИВОСТЬ К РИФАМПИЦИНУ И ИЗОНИАЗИДУ, У ПАЦИЕНТОВ С РАЗНЫМ ВИЧ-СТАТУСОМ

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Клинико-лабораторные различия у больных с локализованной и генерализованной формами саркомы Капоши

The objective: to evaluate clinical and laboratory parameters in local and generalized forms of Kaposi sarcoma (KS) in HIV infected patients to detect predictors of generalized forms of the disease.Subjects and methods. Case histories of 58 HIV infected patients with KS at the age from 28 to 80 years old were respectively analyzed; they all received treatment in National Medical Research Center of Phthisiopulmonology and Infectious Diseases of the Russian Ministry of Health in 2018-2020. Cases were divided into 2 groups depending on KS manifestations. LF group (local form of KS, n = 28) included the patients with skin lesions; GF group (generalized form of KS, n = 30) included patients with skin lesions and one or several lesions in the other sites: the mucous membrane of gastrointestinal tract, the mucous membrane of tracheobronchial tree, and lung parenchyma.Results. Patients with the generalized form of KS had a higher frequency of skin lesions on the body (pχ2 = 0.036), face (pχ2 = 0.033), and multiple sites (pχ2 = 0.018). Patients from both groups had low CD4+ count, but it was more severe in GF group (pχ2 = 0.027) with a significant increase of the viral load (pχ2 = 0.047). The predictors of the generalized form of KS are the following: the presence of specific lesions on the skin of body, face and multiple localizations, CD4 level below 125 cells/mcL, increase in the viral load above 5.3log10 copies/ml, reduction of erythrocytes level below 3.1 × 1012 cells/L. Among 24 patients with KS who had 4-6 predictors, 19 (79.2%) had the generalized form. Among KS patients with not a single predictor, there were no cases of generalized form, as well as there were no cases of local forms among patients who had 5 and 6 predictors.Цель: оценить клинико-лабораторные параметры при локализованной и генерализованной формах саркомы Капоши (СК) у пациентов с ВИЧ-инфекцией для определения предикторов генерализованных форм заболевания.Материалы и методы. Ретроспективно проанализированы истории болезни 58 пациентов с ВИЧ-инфекцией и СК в возрасте от 28 до 80 лет, получавших лечение в ФГБУ «НМИЦ ФПИ» Минздрава России в 2018-2020 гг. Сформированы две группы в зависимости от проявлений СК. В группу ЛФ (локализованная форма СК, n = 28) включены пациенты с поражением кожи, в группу ГФ (генерализованная форма СК, n = 30) ‒ с сочетанием поражений кожи с одним или несколькими поражениями других локализаций: слизистая оболочка желудочно-кишечного тракта, слизистая оболочка трахеобронхиального дерева, паренхима легких.Результаты. У пациентов с генерализованной формой СК отмечалось увеличение частоты поражения кожи на туловище (pχ2 = 0,036), лице (pχ2 = 0,033), а также множественность локализаций (pχ2 = 0,018). Для пациентов обеих групп было характерно снижение уровня CD4+-лим- фоцитов, но более выраженное в группе ГФ (pχ2 = 0,027) при существенном увеличении вирусной нагрузки (pχ2 = 0,047). Предикторами генерализованной формы СК являются: наличие специфических образований на коже туловища, лица и множественных локализаций, снижение уровня CD4 Т-лимфоцитов ниже 125 кл/мкл, повышение вирусной нагрузки выше 5,3 log10 копий/мл, снижение уровня эритроцитов ниже 3,1 × 1012 кл/л. Среди 24 пациентов с СК, имевших 4-6 предикторов, 19 (79,2%) были с генерализованной формой. Среди пациентов с СК, не имевших ни одного предиктора, случаев генерализованной формы не было, также как не было случаев локализованной формы среди пациентов, имевших 5 и 6 предикторов

Резервуар ВИЧ у больных ВИЧ-инфекцией

An HIV reservoir is a collection of HIV DNA in target cells in an HIV-infected person. HIV reservoir in patients with HIV infection prevents eradication of the pathogen and cure of the disease. The review presents published data on the structure of HIV reservoir, its formation and change of its size at different stages of the disease, depending on the time of treatment initiation. The article demonstrates the results of studies that investigated the effect of antiretroviral therapy on the size of the reservoir and the ability to use the size of HIV reservoir as a clinically significant indicator of the course of the disease. The current strategies for influencing on HIV reservoir are considered, the ultimate goal of which is recovery from HIV infection.Резервуар ВИЧ представляет собой совокупность ДНК ВИЧ в клетках-мишенях в организме больного ВИЧ-инфекцией. Резервуар ВИЧ у больных ВИЧ-инфекцией препятствует эрадикации возбудителя и излечению от заболевания. В обзоре представлены данные литературы о структуре резервуара ВИЧ, его формировании и изменении размера резервуара на разных стадиях заболевания в зависимости от сроков начала лечения. Приведены результаты исследований, в которых изучалось влияние антиретровирусной терапии на размер резервуара и возможность использовать размер резервуара ВИЧ в качестве клинически значимого показателя течения заболевания. Рассмотрены современные стратегии воздействия на резервуар ВИЧ, конечной целью которых является выздоровление от ВИЧ-инфекции

Performance of the CMS Cathode Strip Chambers with Cosmic Rays

The Cathode Strip Chambers (CSCs) constitute the primary muon tracking device in the CMS endcaps. Their performance has been evaluated using data taken during a cosmic ray run in fall 2008. Measured noise levels are low, with the number of noisy channels well below 1%. Coordinate resolution was measured for all types of chambers, and fall in the range 47 microns to 243 microns. The efficiencies for local charged track triggers, for hit and for segments reconstruction were measured, and are above 99%. The timing resolution per layer is approximately 5 ns