48 research outputs found

    Chronic and treatment-resistant depression

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    The education of youths placed in out-of-home care

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    The typical educational profile of a youth placed in out-of-home care was developed, and the needs of these students were compared to a variety of educational settings available. The observations made at the Boys & Girls Homes School and the interviews of teachers, administrators, social workers, and youths were then used to develop a method of measuring the success of these youths and the schools they attend. Results showed that as educators apply the principles of individualization while understanding the concepts of resiliency and a solution-focused approach, students who have been placed in out-of-home care will succeed

    RAM$mart Financial Wellness for Health Profession Students

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    College students today are graduating with more debt than ever before. As such, it is critical that our graduates are equipped with the right skills and frame of mind to manage their finances. This includes understanding their income, taxes, and expenses; managing debt; budgeting; saving; and retirement planning. Money management can be intimidating for anyone, regardless of background or education. While online resources are made available to our students, these resources are often overlooked, and do not necessarily set out to engage students or address the issues they may face in a convincing or compelling way. Most of the financial resources easily accessible on the web and on VCU’s sites are intended for undergraduate students. However, graduate students and in particular students in the health sciences professional programs (medicine, dentistry, pharmacy) can accrue a tremendous amount of debt, but are not exposed to as many mandatory or voluntary budgeting and financial resources. The RAMmartFinancialWellnessProgramisasetofonlinemodulesthatwillallowstudentstheopportunitytolearnthebasicprinciplesofmoneyanddebtmanagement.WearefocusingthisphaseonprofessionalstudentsintheSchoolsofMedicine,Pharmacy,andDentistry,withtheintenttoengagethewholeVCUstudentpopulationinthefuture.TheRAMmart Financial Wellness Program is a set of online modules that will allow students the opportunity to learn the basic principles of money and debt management. We are focusing this phase on professional students in the Schools of Medicine, Pharmacy, and Dentistry, with the intent to engage the whole VCU student population in the future. The RAMmart Financial Wellness Program will include modules on a variety of money management topics designed to get the attention of students and to provide them with practical steps they can take at the beginning of, and throughout, their graduate professional education to minimize debt accumulation. There will also be modules designed to inform students of various loan payback options upon their degree completion, and of available community and online financial resources. Through attention-grabbing and entertaining modules, including such things as humorous video snippets and interactive questions, students’ awareness of budgeting and financial responsibility will increase significantly

    L-theanine in the adjunctive treatment of generalized anxiety disorder: a double-blind, randomised, placebo-controlled trial

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    Partial or non-response to antidepressants in Generalized Anxiety Disorder (GAD) is common in clinical settings, and adjunctive biological interventions may be required. Adjunctive herbal and nutraceutical treatments are a novel and promising treatment option. L-theanine is a non-protein amino acid derived most-commonly from tea (Camellia sinensis) leaves, which may be beneficial in the treatment of anxiety and sleep disturbance as suggested by preliminary evidence. We conducted a 10-week study (consisting of an 8-week double-blind placebo-controlled period, and 1-week pre-study and 2-week post-study single-blinded observational periods) involving 46 participants with a DSM-5 diagnosis of GAD. Participants received adjunctive L-theanine (450–900 mg) or matching placebo with their current stable antidepressant treatment, and were assessed on anxiety, sleep quality, and cognition outcomes. Results revealed that adjunctive L-theanine did not outperform placebo for anxiety reduction on the HAMA (p = 0.73) nor insomnia severity on the Insomnia Severity Index (ISI; p = 0.35). However, LT treated participants reported greater self-reported sleep satisfaction than placebo (ISI item 4; p = 0.015). Further, a separation in favour of L-theanine was noted on the ISI in those with non-clinical levels of insomnia symptoms (ISI ≤ 14; p = 0.007). No significant cognitive effects (trail making time and the modified emotional Stroop) were revealed. While this preliminary study did not support the efficacy of L-theanine in the treatment of anxiety symptoms in GAD, further studies to explore the application of L-theanine in sleep disturbance are warranted

    An adjunctive antidepressant nutraceutical combination in treating major depression: study protocol and clinical considerations

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    Current treatment for major depressive disorder (MDD), a prevalent and disabling mental illness, is inadequate, with two-thirds of people treated with first-line antidepressants not achieving remission. MDD is for many a chronic condition, often requiring multiple treatment attempts, thus development of additional interventions is urgently required. An emerging approach to improve non-response to antidepressants is the use of adjunctive nutraceuticals. The pathophysiology of MDD is considered to involve a range of abnormalities (monoamine impairment, neuro-endocrinological changes, reduced brain-derived neurotrophic factor, and cytokine alterations). By targeting an array of these key neurobiological pathways via specific nutraceuticals (S-adenosyl methionine; [SAMe], 5-HTP [active tryptophan], folinic acid [active folic acid], omega-3 fatty acids, and zinc), there is the potential to provide a more comprehensive therapeutic biological approach to treat depression. We are currently conducting a National Health and Medical Research Council funded study in Australia (APP1048222). The clinical trial is phase II/III, multi-site, 3-arm, 8-week, randomised, double-blind, placebo-controlled study using SAMe + folinic acid versus a combination nutraceutical (SAMe, 5-HTP, folinic acid, omega-3, and zinc) or matching placebo in 300 currently depressed participants with diagnosed MDD who are non-responsive to current antidepressants (ANZCTR, protocol number: 12613001300763). The results may provide evidence for a novel adjunctive neurobiological approach for treating depression

    The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

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    Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

    Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

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    AbstractUnderstanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. We observe limited viral introductions into the university; the majority of student cases were linked to a single genetic cluster, likely following social gatherings at a venue outside the university. We identify considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and following a national lockdown. Transmission clusters were largely segregated within the university or the community. Our study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics.</jats:p
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