Art Therapy and Runaway Homeless Youth: An Exploration of Trauma and The Survival Response of Flight

This qualitative case study examined the influencing factors of runaway behavior, trauma, and the survival response of “flight.” The participant, an 18-year-old male residing at a transitional living program, ran away at age 17 and experienced a significant trauma history. Throughout the course of treatment, artwork and clinical notes were used as data. Many themes surfaced in the analysis process, including controlled chaos, body fragmentation, sun symbols, female imagery, and lack of color. The act of running away emerged subtly, whereas, traumatic experiences, chronic in nature and beginning early in life, were acutely evident. While the study was specifically concerned with the “flight” response, due to the age of the client when the traumatic events began, the “freeze” response was more prevalent in his artwork. This suggested that further research with this population may reveal the thread that connects these two survival responses and specifically when the “freeze” response shifts to a “flight” response related to running away behavior

Low prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage in women from former Yugoslavia living in Switzerland

It is erroneous to draw too many conclusions about global university rankings. Making a university’s reputation rest on the subjective judgement of senior academics and over-reliance on interpreting and utilising secondary data from bibliometrics and peer assessments have created an enmeshed culture of performativity and over-emphasis on productivity. This trend has exacerbated unhealthy competition and mistrust within the academic community and also discord outside its walls. Surely if universities are to provide service and thrive with the advancement of knowledge as a primary objective, it is important to address the methods, concepts, and representation necessary to move from an emphasis on quality assurance to an emphasis on quality enhancement.This overview offers an analysis of the practice of international ranking. US News and World Report Best Global Universities Rankings, the Times Supplement World University Rankings, and the Shanghai Jiao Tong University Academic Ranking of World Universities are analysed. While the presence of Nobel laureates in the hard sciences has been seized upon for a number of years as quantifiable evidence of producing world-class university education, Nobel laureates in peace and literature have been absent from such rankings. Moreover, rankings have been based on employment rather than university affiliation. Previously unused secondary data from institutions where Nobel peace and literature laureates completed their terminal degrees are presented. The purpose has been to determine whether including peace and literature laureates might modify rankings. A caveat: since the presence of awarded Nobel laureates affiliated at various institutions results in the institutions receiving additional ranking credit in the hard sciences of physics, chemistry, medicine, and economic sciences, this additional credit is not recognised in the approach used in this study. Among other things, this study suggests that if educational history were used in assembling the rankings as opposed to one’s university affiliation, conclusions might be very different

Weekend diagnosis of Escherichia coli urinary tract infection does not predict poor outcome

It has been suggested that mortality is higher in patients admitted to hospitals during the weekend. The objective of this study was to compare outcomes in patients with E. coli urinary tract infection (UTI) depending on the hospital admission day. For this purpose, a secondary analysis of data from a prospective cohort of patients with E. coli UTI was conducted. Weekend diagnosis of UTI was not associated with higher mortality. However, mortality was associated with sepsis, sepsis-induced hypotension and intensive care unit (ICU) admission. Sepsis-induced hypotension and ICU admission were independent determinants of mortality. The results indicate that indicators of severity of illness are associated with higher mortality in patients with UTI rather than the time of diagnosis

Gram-negative bacteraemia in non-ICU patients: factors associated with inadequate antibiotic therapy and impact on outcomes

Background: A considerable number of Gram-negative bacteraemias occur outside intensive care units (ICUs). Inadequate antibiotic therapy in ICUs has been associated with adverse outcomes; however, there are no prospective studies in non-ICU patients. Methods: A 6 month (1 August 2006–31 January 2007), prospective cohort study of non-ICU patients with Gram-negative bacteraemia in a tertiary-care hospital was performed. Inadequate empirical antibiotic therapy was defined as no antibiotic or starting a non-susceptible antibiotic within 24 h after the initial positive blood culture. Results: Two hundred and fifty non-ICU patients had Gram-negative bacteraemia. The mean age was 56.4 (+16.1) years. The predominant bacteria in monomicrobial infections were Escherichia coli (24%), Klebsiella pneumoniae (18%) and Pseudomonas aeruginosa (8%). Sixty-one (24%) patients had polymi-crobial bacteraemia. Seventy patients (28%) required ICU transfer and 35 (14%) died. Seventy-nine (31.6%) received inadequate empirical antibiotic therapy. These patients were more likely to have a hospital-acquired infection [odds ratio (OR)5 1.99, 95 % confidence interval (CI)5 1.11–3.56, P5 0.02] and less likely to have E. coli monomicrobial bacteraemia [OR 0.40 (95 % CI 0.19–0.86), P5 0.02]. There were no differences in occurrence of sepsis [72 (91.1%) patients with inadequate versus 159 (93.0%

Health-related quality of life in women with endometriosis:psychometric validation of the Endometriosis Health Profile 30 questionnaire using confirmatory factor analysis

STUDY QUESTION: Which of the competing models of the Endometriosis Health Profile 30 Questionnaire (EHP-30) factor structure is best supported by confirmatory factor analysis (CFA)? SUMMARY ANSWER: Findings support a five-factor first-order model of the EHP-30, thereby lending support to the model originally suggested by the questionnaire developers. WHAT IS KNOWN ALREADY: Endometriosis has a negative impact on quality of life, and measures specifically developed to address this impact, such as the EHP-30, are vital in research and disease management. Previous studies have found different models of the EHP-30 factor structure, and generated uncertainty regarding how to use the questionnaire. CFA can be applied to compare competing factor models and determine the underlying structure of a questionnaire. STUDY DESIGN, SIZE, DURATION: This cross-sectional multicenter study included 304 women with endometriosis recruited from three different public health service endometriosis clinics (referral centers for treatment of severe endometriosis) and the Danish Endometriosis Patients Association from 2014 to 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS: Diagnosis of endometriosis was confirmed in medical records for 84.2% and by histology for 66.8% of participants. Questionnaires (the licensed Danish version of the EHP-30) were sent by post two times with a 6- to 12-week interval. CFA was used to examine construct validity and Bland–Altman plots to examine test–retest reliability and the convergent validity with the Short Form 36 version 2. MAIN RESULTS AND THE ROLE OF CHANCE: Response rate was high (87.6%). CFA supported the original first-order five-factor structure of the EHP-30, and thereby, the use of five separate scale-scores in clinical and research practice. Visual inspection of Bland–Altman plots suggested excellent test–retest reliability of the EHP-30 and supported the use of a disease specific quality of life instrument for women with endometriosis. LIMITATIONS, REASONS FOR CAUTION: Diagnosis could not be confirmed through histology data in 33.2% of participants. However, subgroup analyses based on women with confirmed histology only, yielded similar results. Data related to menstrual cycle stage and the use of hormonal and pain medication during questionnaire completion were not collected. A larger study, including data from different countries on different continents, would be better designed to exclude potential population bias. WIDER IMPLICATIONS OF THE FINDINGS: EHP-30, with its original five-factor structure, appears to be a valid, stable, and specific quality of life measure for women with endometriosis. It seems easy to understand, quick to administer, and importantly, scoring might be unaffected by cyclical/menstrual pain symptoms related to endometriosis. The finding of a five-factor model from different studies across several countries supports the crosscultural validity of the EHP-30. STUDY FUNDING/COMPETING INTEREST(S): This work was supported by the Danish Endometriosis Association, which is a nongovernmental organization run by women with endometriosis and by a scholarship from the Health Research Fund of Central Denmark Region. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER: The Danish Data Protection Agency (J.nr: 2013-41-2264)