66 research outputs found
Evaluating the Effect of a Taxane-Based Anti-Cancer Drug on the Adult Taste Organ Using a Mouse Model
Chemosensory alteration is one of the major side effects of chemotherapy that can negatively impact the quality of life of cancer patients. Decreased appetite and food aversions can consequently lead to substantial reductions in food intake and thereby malnutrition and poor patient outcomes. The chemotherapeutic agent, taxane (docetaxel), is an effective choice of treatment for breast cancer, gastric cancer, or prostate cancer. Despite its major effects as an anti-cancer medication, patients under taxane treatments have reported taste alterations. Essentially, the drug disrupts normal microtubule growth by inhibiting microtubule depolymerization. By binding to ß-tubulin, a major component of mitotic spindles, docetaxel (DTX) hyper-stabilizes the microtubule structure, rendering it incapable of properly shortening and elongating. This intrinsic property is especially crucial for chromosome segregation during cell division. DTX also causes apoptosis and peripheral neuropathy. Further, microtubules are essential components of cilia, where Hedgehog (HH) signaling takes place. HH signaling plays a critical regulatory role in taste organ formation and maintenance, while its deregulation can severely disrupt taste perception. Importantly, taxane-based therapies have demonstrated an upregulating effect on HH signaling, but in combination therapies such as with sodium butyrate, it exhibits a down regulating effect. It might be possible that the DTX is causing taste alterations via changes in HH signaling. Alternatively, disruption of cell division can also result in changes in taste cell turnover. The aim of this study is to elucidate whether DTX has an indirect or direct effect on the taste organ and whether it alters HH signaling
An evaluation of compassion focused group psychotherapy for those at the ‘edge of therapeutic opportunity’
The research aimed to evaluate an exploratory Compassion Focused Group Psychotherapy Program and the impact on participants’ experiences of self-criticism, usage of services and general wellbeing. Participants included patients with a history of complex Attachment and Relational Trauma (A&RT), who might attract a diagnosis of personality disorder.
This study utilised a quasi – experimental non-randomised within subject controlled design for the evaluation of the efficacy of Compassion Focused Group Psychotherapy (CFGP). In addition, a qualitative study explored the participants’ experience of this treatment.
Participants were recruited from secondary care and tertiary care services to facilitate a comparison of the two interventions. One Cohort was offered a 12-week Preparation and Engagement intervention (PEG) followed by a 40-week Compassion Focused Trauma Group intervention (CFTG), whilst the other Cohort was offered a 12-week Preparation and Engagement intervention (PEG) and Treatment As Usual (TAU) for 40 weeks. Both Cohorts were followed up after 12 months during which period they received TAU.
A comprehensive selection of self-report measures were administered for completion at various points within the therapeutic process and following completion of the group interventions. The data from these measures were analysed and presented along with the qualitative data.
A sub-sample from the PEG + CFTG Cohort only were invited to participate in a semi structured interview following completion of their treatment. The qualitative data from these interviews was analysed according to a Thematic Analysis protocol.
The results of the research showed that the provision of a long term, slow paced, Compassion Focused Group Psychotherapy intervention, enabled participants to make significant changes across all measures which were maintained at 12 month follow up. These data were supported by a significant reduction in service usage and a significant increase in engagement in employment and education. Coupled with key messages from the qualitative analysis about the importance of safeness, structure and space to return to early trauma as a mechanism for change and psychological growth.
In contrast, participants who received a short-term version of the intervention, initially made dramatic gains but these were not maintained over time
La mobilité locale en Dacie romaine selon les sources épigraphiques: I. Dacie Inférieure
This article belongs to a vaste project about migration at Lower Danube. The local mobility is an important element of this project. The authors analyse the cases concerning local mobility of persons in Dacia Inferior, following the reasons of this mobility. The specificity of this phenomenon in Dacia Inferior consists in militaries’ mobility, for private or official reasons. A special attention is payed to the persons who travelled inside the province, being killed by latrones.Este artÃculo forma parte de un proyecto más amplio sobre la migración en el Danubio Inferior. En el contexto de este proyecto, la movilidad interna de la Dacia constituye un importante elemento. Los autores analizan los casos de la movilidad local de individuos en Dacia Inferior, incidiendo en las razones de esta movilidad. La especificidad de este fenómeno en esta provincia consiste en el desplazamiento de los militares y de antiguos militares, por razones personales u oficiales. Una especial atención es dedicada a las personas que se desplazaban en el interior de la provincia y que eran asesinadas por latrones.Cet article fait partie d’un projet plus vaste concernant la migration au Bas-Danube. Dans le cadre de ce projet, la mobilité interne de la Dacie constitue un élément important. Les auteurs analysent les cas de la mobilité locale des personnes en Dacie Inférieure, tout en suivant les raisons de cette mobilité. La spécificité de ce phénomène dans cette province est fournie par le déplacement des militaires et des anciens militaires, par raisons personnelles ou officielles. Une place particulière est accordée aux personnes qui se sont déplacées à l’intérieur de la province, étant tuées par les brigands
The implementation of resilience based clinical supervision to support transition to practice in newly qualified healthcare professionals
Mucosal injury following short term tracheal intubation: a novel animal model and composite injury score
Objectives: Postintubation laryngotracheal injury is common. Assessment of histopathological changes currently requires animal models. We set about developing a viable, resource effective animal model to study these effects and to develop a detailed tissue injury score.
Methods: Six pigs were anaesthetised using a standard regimen. We intubated the tracheas using a standard endotracheal tube modified to include optical sensors. Animals were anaesthetised for a duration of two to four hours, and their lungs were ventilated using a normoxic gas mixture. Following euthanasia, the tracheas were removed and underwent histological assessment by two independent veterinary pathologists. The histological lesions, including controls, were described and quantified, and two pathologists classified tissues according to a novel injury score.
Results: Mean duration of tracheal intubation was 191 minutes (SD±41.6). In all except one animal, cuff pressures were maintained in the range of 25 – 45 cmH20. Histopathological findings in all study animals showed more extensive changes than previously described with short-term intubation. Changes were seen in all mucosal layers consistent with acute, suppurative and ulcerative tracheitis. The range of scores of the developed composite scoring system among the animals was wider than in earlier descriptions. There was a high percentage of agreement between both pathologists.
Conclusions: We have described a novel tissue injury score to assess pathological changes following short term intubation in a viable animal model. The scoring system distinguished between the test animals as well as controls and may be appropriate for continuing study of intubation injury
Do therapeutic imagery practices affect physiological and emotional indicators of threat in high self-critics?
Objectives: Imagery is known to be a powerful means of stimulating various physiological processes and is increasingly used within standard psychological therapies. Compassion-focused imagery (CFI) has been used to stimulate affiliative emotion in people with mental health problems. However, evidence suggests that self-critical individuals may have particular difficulties in this domain with single trials. The aim of the present study was to further investigate the role of self-criticism in responsiveness to CFI by specifically pre-selecting participants based on trait self-criticism. Design: Using the Forms of Self-Criticism/Self-Reassuring Scale, 29 individuals from a total sample of 139 were pre-selected to determine how self-criticism impacts upon an initial instance of imagery. Methods: All participants took part in three activities: a control imagery intervention (useable data N = 25), a standard CFI intervention (useable data N = 25), and a non-intervention control (useable data N = 24). Physiological measurements (alpha amylase) as well as questionnaire measures of emotional responding (i.e., the Positive and Negative Affect Schedule, the Types of Positive Affect Scale, and the State Adult Attachment Scale) were taken before and after the different interventions. Results: Following both imagery interventions, repeated measures analyses revealed that alpha amylase increased significantly for high self-critics compared with low self-critics. High self-critics (HSC) also reported greater insecurity on entering the imagery session and more negative CFI experiences compared with low self-critics. Practitioner Points: Data demonstrate that HSC respond negatively to imagery interventions in a single trial. This highlights that imagery focused therapies (e.g., CFI) need interventions that manage fears, blocks, and resistances to the techniques, particularly in HSC. An initial instance of imagery (e.g., CFI) can be frightening for people who have a tendency to be self-critical. This research provides examples of physiological and emotional responses to imagery type therapies in high and low self-critics, and associated clinical implications. Therapists may find it helpful to be mindful that when introducing imagery based therapies, highly self-critical patients need interventions that manage fears, blocks, and resistances to the techniques
Fostering Self-Compassion and Loving-Kindness in Patients With Borderline Personality Disorder: A Randomized Pilot Study
The aim of this randomized pilot study is to investigate the effects of a short training programme in loving-kindness and compassion meditation (LKM/CM) in patients with borderline personality disorder. Patients were allocated to LKM/CM or mindfulness continuation training (control group). Patients in the LKM/CM group showed greater changes in Acceptance compared with the control group. Remarkable changes in borderline symptomatology, self-criticism and self-kindness were also observed in the LKM/CMgroup. Mechanistic explanations and therapeutic implications of the findings are discussed. Highlights: ¿ Three weeks of loving-kindness and compassion meditations increased acceptance of the present moment experience in patients with borderline personality disorder. ¿ Significant improvements in the severity of borderline symptoms, self-criticism, mindfulness, acceptance and self-kindness were observed after the LKM/CM intervention. ¿ LKM/CM is a promising complementary strategy for inclusion in mindfulness-based interventions and Dialectical Behavioural Therapy for treating core symptoms in borderline personality disorder
Adapting compassion focused therapy for an adult with a learning disability—A case study
Accessible summary: Compassion focused therapy is a talking therapy. It helps people be kind to themselves. We do not know whether this therapy can help people with learning disabilities. Here, we talk about what happened when a man with a learning disability had the therapy. We hope that other people will use the therapy too. This will improve therapy for people with learning disabilities. Abstract: Background Joe was referred to the Community Learning Disabilities Team (CLDT) for support around low mood and overeating. Initial formulation suggested compassion focused therapy (CFT) as an intervention. The evidence base for using CFT with people with learning disabilities is currently limited. Materials and Methods Adaptations were made to the CFT framework, accounting for Joe's learning disability. A case study design was used to investigate the effectiveness of intervention. Joe attended 13 sessions of assessment, formulation and intervention. Client feedback was incorporated to assess suitability of the CFT approach and adaptations made. Results and Conclusions Changes in scores on outcome measures were limited. However, findings from this exploratory study suggest that CFT can be meaningfully adapted for use within the field of learning disabilities. Implications for clinical practice and directions for future research are discussed.</p
Practical compassions: repertoires of practice and compassion talk in acute mental healthcare
This article reports an exploratory study of the concept of compassion in the work of 20 mental health practitioners in a UK Midlands facility. Using notions of practice derived from phenomenology and Bourdieusian sociology and notions of emotional labour we identify two contrasting interpretive repertoires in discussions of compassion. The first, the practical compassion repertoire, evokes the practical, physical and bodily aspects of compassion. It involves organising being with patients, playing games, anticipating disruption and taking them outside for cigarettes. Practitioners described being aware that these practical, bodily activities could lead to patients ‘opening up’, disclosing their interior concerns and enabling practical, compassionate mental health work to take place. In contrast, the second, organisational repertoire, concerns organisational constraints on compassionate practice. The shortage of staff, the record-keeping and internal processes of quality control were seen as time-greedy and apt to detract from contact with patients. The findings are discussed in relation to Bourdieu and Merleau-Ponty's phenomenological accounts of practice and habit and set in context in the growing interest in placing compassion centrally in healthcare. We also explore how the exercise of compassion in the way our participants describe it can afford the more effective exercise of medical power
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