“You absorb trauma, without noticing it”: A qualitative exploration of staff experiences and subjective well-being working in CAMHS inpatient services.

Background Child and Adolescent Mental Health Service (CAMHS) inpatient staff are lacking representation in the literature, particularly their subjective experiences in the context of well-being. Previous research has tended to be quantitative, with a focus upon an absence of distress or symptomology as indicative of well-being, rather than holistically exploring the felt sense of well-being. The current research aimed to gain a greater understanding of the subjective experiences of CAMHS inpatient staff, the impact of their well-being, and what can be done to support staff in meaningful ways. Method A qualitative research methodology was employed. Recruitment took place across two CAMHS inpatient units and a total of 11 frontline staff from various disciplines participated in the study. Semi-structured interviews were utilised for data collection, data was analysed using thematic analysis. The study was underpinned by a critical-realist position. Findings A total of 10 themes and 16 subthemes were developed from participants’ data. Participants described CAMHS to be both rewarding and stressful, and placed emphasis on the collaborative atmosphere within the wards. Participants felt an enhanced sense of responsibility compared to other settings. The findings also indicated possible Secondary Traumatic Stress within the staff. Participants expressed a need to be held in mind, as well as trying to find ways to overcome barriers to accessing the support offered to them. Discussion Findings are discussed in relation to existing literature and relevant psychological theory. The strengths and limitations of the study are outlined. Consideration is given to the clinical implications, including recommendations for Trauma Risk Management training for staff, revisions to local policies, and meaningful staff consultation during CAMHS inpatient design. Recommendations for future research are presented such as exploring the impact of staff values on subjective well-being, and well-being comparisons between psychiatric intensive care and acute CAMHS settings

The nurses' role in intra-abdominal pressure monitoring in the critical care setting

University of Technology Sydney. Faculty of Health.This thesis provides a unique contribution to the science of IAH and ACS management. Firstly, it has described the state of the science on accepted intra-abdominal pressure measurement techniques, IAH and ACS. Secondly, it has identified that there is a gap in critical care nurses’ knowledge in the topic area. Thirdly it has identified that trauma patients are at risk of developing IAH and ACS, particularly in the presence of massive fluid resuscitation. Fourthly, this thesis has challenged current guidelines on intra-abdominal pressure measurement techniques. Fifthly, this thesis has identified the need for standardised practice guidelines and education to strengthen critical care nurses knowledge, skills and competence in assessing and recognising intra-abdominal hypertension and abdominal compartment syndrome. Future research regarding the effects of intra-abdominal pressure and IAH in discrete patient populations, including post-operative cardiothoracic surgery and type II respiratory failure patients, as well as alternative routes of measurement such as nasogastric measurement are needed. Nurses are well situated to diagnose IAH and management of ACS. Advancing the science of assessment, measurement and management are essential to improving outcomes for individuals with IAH and ACS

Nurse education leaders' perspectives on the teaching of numeracy to undergraduate nursing students : a qualitative research study

Aim The aim of this study was to explore the perspectives of nurse education leaders of Australian undergraduate nursing degrees on the teaching of nursing numeracy and how the Australian Nursing & Midwifery Accreditation Standards influence curriculum development. Background Nurses’ numeracy skills are reportedly deficient worldwide, posing a significant threat to patient safety. This is an issue for the education of undergraduate nurses and thus for the nursing profession. The international literature reveals a heterogeneous blend of learning approaches, but it is unclear which approaches are best suited to improve the numerical calculation ability of nurses. In the Australian context, there are no accreditation standards referring to numeracy, therefore, it is important to discover how nurse education leaders’ design and implement the teaching of numeracy. Design A qualitative approach using thematic analysis was employed. The setting was Australian universities that delivered an accredited undergraduate nursing degree leading to nursing registration. Methods Purposive sampling was used to recruit 17 nurse education leaders of Australian undergraduate nursing degrees. Individual, semi-structured virtual interviews were conducted between November 2022 and January 2023. Interview data were analysed using Braun and Clarke’s (2006) six phases of thematic analysis. Findings Five themes emerged from the analysis: (i) indistinct accreditation standards, (ii) teaching basic maths for clinical applications, (iii) a range of bespoke teaching approaches (iv) we’re nurses, not numeracy educators and (v) assumptions about an unprepared cohort. Conclusion The leaders of undergraduate nursing degrees assumed that nursing students would have proficiency in numeracy skills on entering university. However, this was not the case, hence numeracy was an essential skill that needed to be taught to the undergraduate nursing students. Lack of direction from the accreditation council led to the existence of various curricula and an array of approaches to teaching numeracy and medication calculations, which challenged nursing academics who did not consider themselves numeracy educators. This study makes a novel contribution to knowledge, teaching and practice in undergraduate nursing numeracy curricula

Metastasis of a cecal adenocarcinoma to the prostate five years after a right hemicolectomy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Prostatic metastasis from a primary bowel adenocarcinoma has been only rarely reported in the medical literature. The case reported here is rare in the fact that the primary tumor was from a right-sided bowel adenocarcinoma. It is unusual because initial immunostaining was not fully conclusive, and so a relatively new method of immunostaining, CDX2, was used to ascertain its histopathology.</p> <p>Case presentation</p> <p>We describe the case of a 54-year-old Caucasian man who had a right hemicolectomy for a primary cecal adenocarcinoma, which was completely excised. Following the procedure, he received adjuvant chemotherapy. Computed tomography scans showed no evidence of local recurrence or metastatic disease. Then, five years later, he presented to his general practitioner with urinary symptoms. An abnormal prostate was palpated on digital rectal examination. Trans-rectal prostatic biopsies were performed, which showed colorectal metastases within the prostate gland. This was confirmed with CDX2 immunohistochemistry. There was no further evidence of distant metastases on positron emission tomography-computed tomography scans.</p> <p>Conclusions</p> <p>This case demonstrates a rare isolated hematogenous spread to the prostate from a primary cecal adenocarcinoma, several years after definitive treatment and excision. This highlights the importance of accurate immunohistochemistry and imaging in planning further management and treatment.</p

Atypical functional connectivity during unfamiliar music listening in children with autism

Background: Atypical processing of unfamiliar, but less so familiar, stimuli has been described in Autism Spectrum Disorder (ASD), in particular in relation to face processing. We examined the construct of familiarity in ASD using familiar and unfamiliar songs, to investigate the link between familiarity and autism symptoms, such as repetitive behavior. Methods: Forty-eight children, 24 with ASD (21 males, mean age = 9.96 years ± 1.54) and 24 typically developing (TD) controls (21 males, mean age = 10.17 ± 1.90) completed a music familiarity task using individually identified familiar compared to unfamiliar songs, while magnetoencephalography (MEG) was recorded. Each song was presented for 30 s. We used both amplitude envelope correlation (AEC) and the weighted phase lag index (wPLI) to assess functional connectivity between specific regions of interest (ROI) and non-ROI parcels, as well as at the whole brain level, to understand what is preserved and what is impaired in familiar music listening in this population. Results: Increased wPLI synchronization for familiar vs. unfamiliar music was found for typically developing children in the gamma frequency. There were no significant differences within the ASD group for this comparison. During the processing of unfamiliar music, we demonstrated left lateralized increased theta and beta band connectivity in children with ASD compared to controls. An interaction effect found greater alpha band connectivity in the TD group compared to ASD to unfamiliar music only, anchored in the left insula.Conclusion: Our results revealed atypical processing of unfamiliar songs in children with ASD, consistent with previous studies in other modalities reporting that processing novelty is a challenge for ASD. Relatively typical processing of familiar stimuli may represent a strength and may be of interest to strength-based intervention planning.info:eu-repo/semantics/publishedVersio

UNBOUND

Featured here, are the extraordinary works of our graduating Fanshawe Design class. This accomplishment is truly a celebration of the three years of passion, hard work, and dedication put forth by our students. It is our greatest hope that family, friends and the fashion industry will enjoy the creative endeavors of these emerging designers from the Fashion Design program at Fanshawe College in London, Ontario.https://first.fanshawec.ca/famd_design_fashiondesign_unbound/1001/thumbnail.jp

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

The CLIMATE schools combined study: a cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxiety

Background: Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents. Methods/design: Participants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined.Discussion: Compared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge