86 research outputs found
Differences and similarities in instant countertransference towards patients with suicidal ideation and personality disorders.
Previous findings showed that suicidal patients elicit mostly negative countertransference such as distress, hopelessness, feelings of inadequacy, and apprehension, and that a concurrent personality disorder is associated with more feelings of entrapment and mistreatment, among other adverse reactions. No studies were however conducted on instant countertransference (iCT), i.e., after a single encounter, for example in an emergency setting. We aimed to evaluate the impact of suicidal ideations, self-harm and presence of personality disorders on instant Countertransference (iCT).
Caregivers rated their iCT with two validated and standardized questionnaires after a first emergency or outpatient consultation. Suicidal ideation, self-harm and personality disorders were tested as predictors for iCT in a multivariate and multilevel analysis.
Thirty caregivers rated their iCT towards 321 patients. Personality disorders and suicidal ideation, but neither recent nor past history of self-harm, predicted iCT. Common iCT included tension, lack of self-confidence and feeling of being tied. iCT specifically associated with suicidal ideation included distress, lack of hope, confusion, and sense that the patient's life had little worth. In contrast, iCT towards patients with personality disorders suggested tension in the therapeutic relationship (low affiliation with patient, anger, disappointment, devaluation).
Caregiver's characteristics were not considered in the analysis. Furthermore, while countertransference also includes unconscious phenomena, only conscious iCT was assessed.
Patients with suicidal ideation and personality disorders elicit common but also specific negative iCT. Mental health institutions need to devote specific resources (such as clinical supervision and training) to help caregivers manage their iCT
Surface composition and properties of Ganymede: Updates from ground-based observations with the near-infrared imaging spectrometer SINFONI/VLT/ESO
Ganymede's surface exhibits great geological diversity, with old dark terrains, expressed through the surface composition, which is known to be dominated by two constituents: H2O-ice and an unidentified darkening agent. In this paper, new investigations of the composition of Ganymede's surface at global scale are presented. The analyses are derived from the linear spectral modeling of a high spectral resolution dataset, acquired with the near-infrared (1.40–2.50 μm) ground-based integral field spectrometer SINFONI (SINgle Faint Object Near-IR Investigation) of the Very Large Telescope (VLT hereafter) located in Chile. We show that, unlike the neighboring moon Europa, photometric corrections cannot be performed using a simple Lambertian model. However, we find that the Oren-Nayar (1994) model, generalizing the Lambert's law for rough surfaces, produces excellent results. Spectral modeling confirms that Ganymede's surface composition is dominated by H2O-ice, which is predominantly crystalline, as well as a darkening agent, but it also clearly highlights the necessity of secondary species to better fit the measurements: sulfuric acid hydrate and salts, likely sulfates and chlorinated. A latitudinal gradient and a hemispherical dichotomy are the strongest spatial patterns observed for the darkening agent, the H2O-ice, and the sulfuric acid: the darkening agent is by far the major compound at the equator and mid-latitudes (≤ ± 35°N), especially on the trailing hemisphere, while the H2O-ice and the sulfuric acid are mostly located at high latitudes and on the leading hemisphere. This anti-correlation is likely a consequence of the bombardment of the constituents in the Jovian magnetosphere which are much more intense at latitudes higher than ±35°N. Furthermore, the modeling confirms that polar caps are enriched in small, fresh, H2O-ice grains (i.e. ≤50 μm) while equatorial regions are mostly composed of larger grains (i.e. ≥200 μm, up to 1 mm). Finally, the spatial distribution of the salts is neither related to the Jovian magnetospheric bombardment nor the craters. These species are mostly detected on bright grooved terrains surrounding darker areas. Endogenous processes, such as freezing of upwelling fluids going through the ice shell, may explain this distribution. In addition, a small spectral residue that might be related to brines and/or hydrated silica-bearing minerals are located in the same areas
Toxocariasis: a silent threat with a progressive public health impact
Background: Toxocariasis is a neglected parasitic zoonosis that afflicts millions of the pediatric and adolescent populations worldwide, especially in impoverished communities. This disease is caused by infection with the larvae of Toxocara canis and T. cati, the most ubiquitous intestinal nematode parasite in dogs and cats, respectively. In this article, recent advances in the epidemiology, clinical presentation, diagnosis and pharmacotherapies that have been used in the treatment of toxocariasis are reviewed.
Main text: Over the past two decades, we have come far in our understanding of the biology and epidemiology of toxocariasis. However, lack of laboratory infrastructure in some countries, lack of uniform case definitions and limited surveillance infrastructure are some of the challenges that hindered the estimation of global disease burden. Toxocariasis encompasses four clinical forms: visceral, ocular, covert and neural. Incorrect or misdiagnosis of any of these disabling conditions can result in severe health consequences and considerable medical care spending. Fortunately, multiple diagnostic modalities are available, which if effectively used together with the administration of appropriate pharmacologic therapies, can minimize any unnecessary patient morbidity.
Conclusions: Although progress has been made in the management of toxocariasis patients, there remains much work to be done. Implementation of new technologies and better understanding of the pathogenesis of toxocariasis can identify new diagnostic biomarkers, which may help in increasing diagnostic accuracy. Also, further clinical research breakthroughs are needed to develop better ways to effectively control and prevent this serious disease
Lancet
BACKGROUND: In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival as a metric of the effectiveness of health systems and to inform global policy on cancer control. CONCORD-3 updates the worldwide surveillance of cancer survival to 2014. METHODS: CONCORD-3 includes individual records for 37.5 million patients diagnosed with cancer during the 15-year period 2000-14. Data were provided by 322 population-based cancer registries in 71 countries and territories, 47 of which provided data with 100% population coverage. The study includes 18 cancers or groups of cancers: oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast (women), cervix, ovary, prostate, and melanoma of the skin in adults, and brain tumours, leukaemias, and lymphomas in both adults and children. Standardised quality control procedures were applied; errors were rectified by the registry concerned. We estimated 5-year net survival. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: For most cancers, 5-year net survival remains among the highest in the world in the USA and Canada, in Australia and New Zealand, and in Finland, Iceland, Norway, and Sweden. For many cancers, Denmark is closing the survival gap with the other Nordic countries. Survival trends are generally increasing, even for some of the more lethal cancers: in some countries, survival has increased by up to 5% for cancers of the liver, pancreas, and lung. For women diagnosed during 2010-14, 5-year survival for breast cancer is now 89.5% in Australia and 90.2% in the USA, but international differences remain very wide, with levels as low as 66.1% in India. For gastrointestinal cancers, the highest levels of 5-year survival are seen in southeast Asia: in South Korea for cancers of the stomach (68.9%), colon (71.8%), and rectum (71.1%); in Japan for oesophageal cancer (36.0%); and in Taiwan for liver cancer (27.9%). By contrast, in the same world region, survival is generally lower than elsewhere for melanoma of the skin (59.9% in South Korea, 52.1% in Taiwan, and 49.6% in China), and for both lymphoid malignancies (52.5%, 50.5%, and 38.3%) and myeloid malignancies (45.9%, 33.4%, and 24.8%). For children diagnosed during 2010-14, 5-year survival for acute lymphoblastic leukaemia ranged from 49.8% in Ecuador to 95.2% in Finland. 5-year survival from brain tumours in children is higher than for adults but the global range is very wide (from 28.9% in Brazil to nearly 80% in Sweden and Denmark). INTERPRETATION: The CONCORD programme enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed worldwide every year. It contributes to the evidence base for global policy on cancer control. Since 2017, the Organisation for Economic Co-operation and Development has used findings from the CONCORD programme as the official benchmark of cancer survival, among their indicators of the quality of health care in 48 countries worldwide. Governments must recognise population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer. FUNDING: American Cancer Society; Centers for Disease Control and Prevention; Swiss Re; Swiss Cancer Research foundation; Swiss Cancer League; Institut National du Cancer; La Ligue Contre le Cancer; Rossy Family Foundation; US National Cancer Institute; and the Susan G Komen Foundation
A ring system detected around the Centaur (10199) Chariklo
Until now, rings have been detected in the Solar System exclusively around the four giant planets. Here we report the discovery of the rst minor-body ring system around the Centaur object (10199) Chariklo, a body with equivalent radius 124±9 km. A multi-chord stellar occultation revealed the presence of two dense rings around Chariklo, with widths of about 7 km and 3 km, optical depths 0.4 and 0.06, and orbital radii 391 and 405 km, respectively. The present orientation of the ring is consistent with an edge-on geometry in 2008, thus providing a simple explanation for the dimming of Chariklo's system between 1997 and 2008, and for the gradual disappearance of ice and other absorption features in its spectrum over the same period. This implies that the rings are partially composed of water ice. These rings may be the remnants of a debris disk, which were possibly con ned by embedded kilometre-sized satellites
Evolution of pleural cancers and malignant pleural mesothelioma incidence in France between 1980 and 2005.
The evolution of pleural cancers and malignant pleural mesothelioma incidence in France between 1980 and 2005 was analysed using data derived from the French network of cancer registries (FRANCIM) and the French National Mesothelioma Surveillance Program (PNSM). Mesothelioma proportions in pleural cancers were calculated by diagnosis year in the 1980-2000 period. Our results suggest that the incidences of pleural cancer and mesothelioma levelled off in French men since 2000 and continued to increase in French women. A decrease of the annual pleural cancer incidence average in men was noticed (-3.4% of annual rate of change) between 2000 and 2005. The proportion of pleural cancers that were mesothelioma was unchanged between 1980 and 2003 with an average of 86%. The age standardised incidence rate of pleural mesothelioma remained relatively stable between 1998 and 2005 with a slight falling trend. For women, the age standardised incidence rate of pleural cancers and mesothelioma increased during the period 1998-2005. Additionally, the proportion of pleural cancers that were mesothelioma increased during the same period of time. Finally, the increased trend observed in the incidence of pleural mesothelioma and cancers in women is credibly due to their under diagnosis in the 1980-1997 period. The comparison between the French incidence and the American and British ones shows that the decreasing trend in incidence of mesothelioma and pleural cancers in French men since 2000 is potentially associated with a lower amphibole consumption and by the implementation of safety regulations at work from 1977
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