Mindfulness: A Systematic Review

A systematic review of the mindfulness literature is conducted. A sample of 54 academic articles was created and an analysis of the empirical evidence on the effects of mindfulness on work-related outcomes and processes—such as employee performance, leadership, and ethical decision making—was conducted. The sample was analyzed to address four underlying issues in the literature: (1) the need for a complete definition of mindfulness, (2) the need for more developed theory, (3) the difficulties associated with operationalizing mindfulness, and (4) to identify gaps in the literature and areas for future research. We conclude that: (1) there may be different forms of mindfulness practice in organizations that impact varying aspects of organizational effectiveness and (2) the study and application of mindfulness in organizations offers promising directions; however, more research is needed to create a basis of evidence for successful mindfulness training programs. Further, a deeper understanding of the theories used to understand the mechanisms, consequences, and conditions of mindfulness would benefit organizational effectiveness

Apraksija udova kod multiple skleroze

Background/Aim. There are almost no studies on apraxia in people with multiple sclerosis. Although the white matter is damaged in MS, it is not the only location in which the pathological changes are present. Demyelinated lesions in the cortex have recently been recognized as important components of multiple sclerosis pathology. The aim of this study was to determine whether apraxia is present among people with MS, and the importance of demographic characteristics and impairment of functional systems at conceptualization and execution of movements. Methods. The experimental group consisted of 30 patients, mean age 51.34 ± 7.70 years. The patients in the experimental group were diagnosed with MS according to the McDonald criteria. The control group consisted of 30 healthy subjects, mean age 50.30 ± 10.47 years. For research purposes, we used the following instruments: Questionnaire for Collecting Demographic Data, Kurtzke Functional Systems Scores, Waterloo-Sunnybrook Apraxia Battery (WatAB). Execution of motion tasks that are a part of the WatAB were incorporated in the System for the Observation and Analysis of Motor Behavior. Results. Our study showed that limb apraxia was common in people with MS. Apraxia was present during pantomime in 26.70% of the patients, and during the imitation of movements in 44.80% of the patients. Gender, age, education level, duration of disease and a form of MS did not determine the quality of conceptualization and execution of movements. The time elapsed from the last exacerbation was a determinant of quality of executed movements. Impairments of functional systems predicted impairments of movement execution. The expanded disability scale score correlated with the severity of apraxia. Conclusion. Our study confirm the presence of apraxia in MS. It is necessary to carry out further studies using functional magnetic resonance imaging, as well as the conduct longitudinal studies to determine the precise structure of motor behavior in people with MS.Uvod/Cilj. Istraživanja apraksije kod osoba sa multiplom sklerozom (MS) gotovo da nema. Iako je oštećenje bele mase prisutno, ono ne predstvlja jedinu lokaciju u CNS-u na kojoj su prisutne patološke promene kod MS. U skorije vreme smatra se da je kora velikog mozga veoma važna lokacija na kojoj dolazi do patoloških promena kod osoba koje boluju od MS. Cilj ovog istraživanja bio je da se utvrdi da li među osobama sa MS ima onih kod kojih je prisutna apraksija, kao i značaj demografskih karakteristika i oštećenja funkcionalnih sistema za konceptualizaciju i izvođenje pokreta. Metode. Eksperimentalnu grupu činilo je 30 učesnika starosti 51,34 ± 7,70 godina. Učesnicima eksperimentalne grupe dijagnostikovana je MS prema Mekdonaldovom dijagnostičkom kriterijumu. Kontrolnu grupu sačinjavalo je 30 zdravih osoba starosti 50,30 ± 10,47 godina. Za potrebe istraživanja korišćeni su podaci dobijeni Upitnikom za prikupljanje demografskih podataka i osnovnih podataka o bolesti, Kurzke-ovim skorovima funkcionalnih sistema i Adaptiranom Vaterlo baterijom za procenu apraksije (ova baterija korišćena je u kombinaciji sa Sistemom za opservaciju i analizu motornog ponašanja). Rezultati. Naše istraživanje je pokazalo da apraksija udova predstavlja čestu pojavu od osoba sa MS. Apraksija na zadacima izvođenja pantomime bila je prisutna kod 26,70% bolesnika, a na zadacima izvođenja imitacije pokreta kod 44,80% bolesnika. Pol, godine života, stepen obrazovanja, dužina trajanja bolesti i oblik bolesti nisu determinisali kvalitet konceptualizacije i izvođenja pokreta kod osoba sa MS. Vreme proteklo od poslednje egzacerbacije predstavljalo je determinantu kvaliteta izvedenih pokreta. Oštećenja funkcionalnih sistema kod osoba sa MS predviđala su pristustvo oštećenja izvršenja pokreta. Proširena skala funkcionalne onesposobljenosti bila je u korelaciji sa težinom apraksije. Zaključak. Naše istraživanje otkrilo je prisustvo apraksije kod MS. Potrebno je izvršiti dalja istaživanja uz korišćenje funkcionalne magnetne rezonance, kao i sprovođenje longitudinalnih studija kako bi se preciznije utvrdila struktura motornog ponašanja kod osoba sa MS

Détection des ARNnc dans les séquences génomiques. Application au génome de Ralstonia solanacearum

Les ARN non-codant sont des régulateurs clés des divers processus cellulaires, chez les procaryotes et les eucaryotes. Malgré le grand nombre des ARN non-codant connus à ce jour il n'existe pas de méthode bioinformatique universelle permettant leur détection. Il est connu que, dans les genomes archéans A+T riches hyperthermophiles, la détection est possible à l'aide de leur composition en G+C elevée dans ces génomes. Ici nous étudions l'approche par biais de composition pour la détection des ARN non-codant dans le génome G+C riche de Ralstonia solanacearum pour lequel aucun étude de recherche des ARNnc n'a pas été menée à ce jour. Nous étudions tout d'abord l'existence d'un biais de composition dans les ARNnc du génome A+T riche de Staphylococcus aureus. D'un point de vue méthodologique, ce travail propose une procédure pour tester l'existence d'un biais en G+C dans différents éléments génomiques. La procédure est basée sur la theorie des Modeles Lineaires Generalises. Nous montrons que les ARNnc de S. aureus ensemble avec certaines séquences repetées, sont caracterisées par le G+C% plus elevée et ceci peut être utilisé pour leur détection. La même approche à été utilisée avec moins de succès sur le génome de R. somanacearum. De façon complémentaire a l'approche par biais de composition, nous avons utilise l'analyse comparative des différentes souches de R. solanacearum pour la détection des ARNnc conserves. Nous avons développe la nouvelle version de RNAsim, un outil utilisant la théorie des graphes pour identifier les régions intergeniques conservées entre plusieurs génomes. Les candidats choisis a l'aide de l'approche comparative ont été analyses par rapport a la conservation de leur structure secondaire, éléments de syntenie etc. afin d'évaluer leur pertinence biologique. Huit candidats ont été sélectionnes et ils seront testes biologiquement.Recently, noncoding RNAs (ncRNAs) have emerged as key regulators in control of diverse cellular processes both in procaryotes and eucaryotes. Despite a great number of noncoding RNA known today, no universal feature allowing their reliable prediction has been found. Nevertheless, it is known that in archean A+T rich thermophiles ncRNA detection is possible on the basis on their elevated G+C contents. On the other hand, there are no studies exploring the compositional properties of noncoding RNA in G+C rich genomes. Here we study the noncoding RNA detection in Ralstonia solanacearum G+C rich beta-proteobacterium in which no previous systematic search of noncoding RNAs had been undertaken.e first studied the existence of the compositional bias in ncRNAs in A+T rich bacterium Staphylococcus aureus. From the methodological point of view, this work resulted in proposition of a procedure for testing the G+C bias in different genomes features, and noncoding RNA in particular, based on the Generalised Linear Modelling. We show that S. aureus ncRNAs, as well as some repeat sequences, are caracterised by a significant compositional bias which can be used for their detection. The same approach was less succesiful when applied on R. solanacearum genome. Complementary to the compositional bias approach, we used the comparative genome analysis between different strains of R. solanacearum in order to detect conserved noncoding RNA. During this work, we developed a new version of RNAsim, a tool using graph theory approach in order to predict conserved intergenic regions in multiple genomes. The candidates selectionned on their conservation were analysed on the basis of their secondary structure conservation, elements of synteny and other features, in order to determine their biological relevance. Eight candidates were selected and theirtranscription will be tested biologically

Abdominal Pain Patient Referrals to Emergency Surgical Service: Appropriateness of Diagnosis and Attitudes of General Practitioners

This study evaluate the need for general practitioners referrals and self referrals of acute abdominal pain patients to emergency surgical service, the appropriateness of GP referral diagnosis and their attitudes dealing with abdominal pain. In three months period all acute abdominal pain patient referrals to our hospital emergency surgical service were audited. Data on final diagnosis, surgical treatment, admission to hospital and surgery performance were recorded. Self referral or GP referral, referring GP diagnosis, referral letters indicating presenting complaint or history, axillar and rectal temperature measurement, laboratory checking and abdominal radiography checking by GP were recorded as well. Also, GPs examination details as palpation, auscultation and digit-rectal checking were recorded. We calculated sensitivity, specificity, positive and negative predictive value (PV) for referring diagnosis. Self referrals and GP referrals differences were evaluated. During the study 318 patients were admitted. A total of 163 (51.25%) referrals were deemed inappropriate; 102 (52.6% of GP referrals) and 61 (49.2% of self referred) (p<0.05). There were no differences in general treatment, hospital admission and operative treatment in self referred and GP referred groups (p<0.05 for all three categories). Sensitivity, specificity, positive and negative predictive values for most frequent GP referral diagnoses were: abdominal colic/abdomen in observation 0.78; 0.66; 0.74; 0.70; acute appendicitis 0.37; 0.92; 0.44; 0.90; acute abdomen/peritonitis 0.30; 0.97; 0.54; 0.92; constipation 0.95; 0.98; 0.85; 0.99; and ileus 0.83; 0.97; 0.50; 0.99. Data on GP including clinical examination, patient history and running basic diagnostics were poor. Our results suggest that a general agreement within the profession about what constitutes a »necessary« hospital referral is necessary. GP consultation quality must be improved by booking more time per patient and by giving more medical/technical attention to patients

Sakrale Neuromodulation bei neurogenen Blasenfunktionsstörungen

Zusammenfassung: Die sakrale Neuromodulation (SNM) stellt bei therapierefraktären neurogenen Blasenfunktionsstörungen eine vielversprechende Therapieoption dar. Es bleibt allerdings zu zeigen, welche Typen der neurogenen Blasenfunktionsstörungen und welche zugrunde liegenden neurologischen Erkrankungen am besten auf die SNM ansprechen. Die SNM wurde ständig weiterentwickelt und ist heute ein minimal-invasives, in Lokalanästhesie durchführbares Therapieverfahren, das vor größeren rekonstruktiven Eingriffen zumindest erwogen werden sollte. Es wird eine Elektrodenimplantation ins Sakralforamen S3 oder S4 durchgeführt und in einer Testphase über Tage bis Wochen unter Führen eines Blasentagebuches geprüft, ob die SNM dem Patienten einen relevanten Nutzen bringt. Wenn sich eine positive Testphase zeigt, wird der Neuromodulator gluteal (oder seltener in die Bauchdecke) implantiert. Der Wirkmechanismus der SNM ist nicht gänzlich geklärt, doch Afferenzen dürften eine Schlüsselrolle spielen. So scheint die SNM via periphere Afferenzen eine Modulation von Rückenmarkreflexen und Gehirnzentren zu bewirken. Das implantierte Neuromodulationssystem führt zu keiner Einschränkung der Aktivitäten der Patienten. Allerdings gilt es zu beachten, dass bei Neuromodulatorträgern Hochfrequenzwärmetherapie und unipolare Elektrokauterisation kontraindiziert sind, dass bei einer extrakorporellen Stoßwellenlithotripsie der Brennpunkt nicht in unmittelbarer Nähe des Neuromodulators oder der Elektrode liegen darf, dass Ultrasonographie und Strahlentherapie im Bereich der Implantatkomponenten vermieden werden sollten, dass bei Schwangerschaft der Neuromodulator auszuschalten ist und dass MR-Untersuchungen nur bei zwingender Indikation und bei ausgeschaltetem Neuromodulator durchgeführt werden solle

THE INFLUENCE OF DIFFERENT TYPES OF BRACKETS AND EFFICACY OF TWO CHLORHEXIDINE MOUTHWASHES ON ORAL HYGIENE AND THE INCIDENCE OF WHITE SPOT LESIONS IN ADOLESCENTS DURING THE ORTHODONTIC THERAPY

Background: To detect the effect of two different types of brackets (ceramic and stainless steel) and investigate the effectiveness of two chlorhexidine mouthwashes 0.2% (CHX) on oral hygiene status and incidence of white spot lesions (WSLs) in adolescents wearing fixed orthodontic appliance. Subjects and methods: One hundred and twenty subjects (aged 11 to 18 years, mean age 14.5 years) were divided into six equal groups according to brackets type and to different mouthwashes: Group 1: metal brackets and conventional CHX, Group 2: metal brackets and CHX with anti-discoloration system (CHX-ADS), Group 3: ceramic brackets and conventional CHX, Group 4: ceramic brackets and CHX-ADS, Group 5: metal brackets and water correction flavors mouthwash (placebo), Group 6: ceramic brackets and placebo. Four weeks after the placement of fixed orthodontic appliance the subjects were provided with three different mouthwashes for use during the next two weeks. Assessment was carried out according to oral hygiene index-simplified (OHI-S) and WSL index performed: prior to placement of the appliance (baseline), four weeks, six weeks, eighteen weeks, and thirty weeks after the placement. The data were then subjected to statistical analysis. Results: Group 4 showed reduction in the OHI-S scores when compared to the Group 5 (in the 6th week), and Group 6 (in the 6th and 18th week), which was statistically significant, P<0.05. Group 4 showed decrease in the WSLs scores when compared to the Group 1 (in the 4th, 6th, 18th and 30th week), Group 5 (in the 18thand 30th week) and Group 6 (in the 6th, 18th and 30th week), which was statistically significant, P<0.05. Conclusion: The ceramic brackets and the usage of CHX-ADS resulted in better oral hygiene status and lower incidence of WSLs

WORKPLACE STRESS IN THE UNIVERSITY CLINICAL SETTINGS: COMPARISON BETWEEN THE CARDIAC UNIT AND EMERGENCY CENTER MEDICAL STAFF

Background: Stress at work is a specific type of stress arising from the wor k environment. Stress of the medical staff has been investigated in recent years by the medical institutions of different countries. The aim of this study was to examine the stres s levels in medical staff of Department of Cardiac Surgery and Center of emergency medicine (CEM) in the Clinical settings, and to compare them. Subjects and methods : We conducted a cross-sectional study which included 55 patients between 21 and 50 years of age. The study group consisted of 30 employees from the Department of Cardiac Surgery of Mostar University Clinical Hospital, while the control group comprised 25 employees from the CEM. Research instruments were the Occupational Stress Questionnaire for Hospital Health Care Workers (OSQ-HHCW), General Health Questionnaire (GHQ 28) and a Stress MGMT-TEST A. Results: The subjects from the control group had significantly higher stress experience in “bombing” with new information (p=0.028), unavailability of literature (p=0.039), poor communication with superiors (p<0.001), conflicts with patients (p=0.04 2) and inappropriate public criticism (p=0.007). The highest stress level showed F1 group of stressors, concerning the organizatio n of work and funding. CEM employees had statistically significantly higher level of stress on public criticism and lawsuits compare d to the study group (p=0.013), as well as higher score on the anxiety/insomnia subscale (p<0.001), social dysfunction scale (p=0.00 2) and on the depression subscale (p<0.001). Conclusions: Stressors from the group of organizational factors have proven to be the most common stressors in both groups. However, in some areas within the impact of workplace stress, CEM employees had significantly greater vulnerability compared to employees of the Department of cardiac surgery. Further studies are needed to establish the frequency and intensity of stress a mong health professionals, and to clearly determine the risk factors for its development

Metastatic Malignant Melanoma Causing Small Bowel Intussusception: A Case Report with 4-year Follow-up

Primary mucosal malignant melanoma of the small bowel is extremely rare. The small bowel is mostly affected by metastases of the primary malignant melanoma of the skin. Bowel obstruction is a rare complication of metastatic melanoma. We present a case of small bowel obstruction in a 49-year-old man with history of skin malignant melanoma. A segmental resection of the ileum with termino-terminal anastomosis was performed. Pathohistological examination showed metastatic melanoma. After 4 years of follow-up, the patient is still free of the disease

Schwere Lithiumintoxikationen bei normalen Serumspiegeln

Anliegen Unser Ziel ist es, Faktoren zu identifizieren, die das Risiko einer Lithiumintoxikation trotz normaler Serumspiegel erhöhen. Methode Wir beschreiben zwei eigene Fälle und bewerten diese im Kontext der Literatur. Ergebnisse Alter, Begleiterkrankungen und psychopharmakologische Komedikation erhöhen das Risiko einer Lithiumintoxikation bei normalen Serumspiegeln. Diskussion Bei älteren, multimorbiden Patienten sollte eine engmaschige klinische Kontrolle inklusive Spiegelbestimmung und EEG erfolgen, bei klinischen Anzeichen der Intoxikation sollte auch bei unauffälligen Spiegeln ein Absetzen erwogen werden