1,053 research outputs found

    The relevance of professionals’ attachment style, expectations and job attitudes for therapeutic relationships with young people who experience psychosis

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    Background: Therapeutic relationships are a central component of community treatment for psychosis and thought to influence clinical and social outcomes, yet there is limited research regarding the potential influence of professional characteristics on positive therapeutic relationships in community care. It was hypothesised that professionals’ relating style and attitudes toward their work might be important, and thus this exploratory study modelled associations between these characteristics and therapeutic relationships developed in community psychosis treatment. Methods: Dyads of professionals and young patients with psychosis rated their therapeutic relationships with each other. Professionals also completed measures of attachment style, therapeutic optimism, outcome expectancy, and job attitudes regarding working with psychosis. Results: Professionals’ anxious attachment predicted less positive professional therapeutic relationship ratings. In exploratory directed path analysis, data also supported indirect effects, whereby anxious professional attachment predicts less positive therapeutic relationships through reduced professional therapeutic optimism and less positive job attitudes. Conclusions: Professional anxious attachment style is directly associated with the therapeutic relationship in psychosis, and indirectly associated through therapeutic optimism and job attitudes. Thus, intervening in professional characteristics could offer an opportunity to limit the impact of insecure attachment on therapeutic relationships in psychosis

    Nasal Bone Fractures and the Use of Radiographic Imaging: An Otolaryngologist Perspective

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    Objective To determine radiologic preferences of practicing otolaryngologists regarding isolated nasal bone fractures. Study design An 8-question survey on isolated nasal bone fractures was designed. Setting Surveys were sent to all otolaryngology residency program directors for distribution among residents and faculty. Additional surveys were distributed to private practice otolaryngology groups. Results 140 physicians responded to the survey. 57% of the respondents were practicing otolaryngologists (75% with 10+ years of experience), while 43% of respondents were residents-in-training. 56% of respondents treated 1–5 nasal bone fractures per month. 80% of all respondents reported imaging being performed prior to consultation. If imaging was obtained before consultation, plain films and computed tomography (CT) maxillofacial/sinus scans were the most frequent modalities. 33% of residents and 70% of practicing otolaryngologists report imaging as ‘rarely’ or ‘never’ helpful in guiding management. 42% of residents and 20% of practicing otolaryngologists report asking for imaging when it wasn't already obtained. Decreased use of radiography was associated with greater years in practice and higher frequency of fractures treated. Conclusions and relevance Otolaryngologists seldom request imaging to evaluate and treat isolated nasal bone fractures. When ordered, imaging is utilized more often among residents-in-training and non-otolaryngology consulting physicians. This study highlights an opportunity to educate primary care and emergency room providers as well as otolaryngology residents on the value of comprehensive physical exam over radiographic imaging in the work-up of isolated nasal fractures. In addition, widespread adoption of a “no x-ray policy” in this setting may result in better resource utilization

    The Making of Modern America: Quantifying Chaos

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    As we begin to explore the Gilded Age (1870-1900), that era in American History sandwiched between the Civil War/Reconstruction and the Progressive Era to the Great War, we want students to grasp the enormity of the changes impacting the lives of Americans who have largely been engaged in farming in many cases not so different than their ancestors had for several hundreds of years. Technological changes in the first half of the 19th century contributed to some mechanization and manufacturing, but the enormity of the Civil War and the acquisition of the entire continental territory in the 1850s, accelerated changes in the production of goods, in the development of communication and transportation, in the growth of cities, in the opportunities for immigrants, for participation in politics, and in the reach of the government. In this lesson, students will dip into the many changes over the decades from 1860 to 1900 by searching for information on a variety of topics, including: Banking or Finance, Demographics, Government, Industrialization, Immigration, Middle Class Angst, Military, Natural Resources, Politics, Racism, Robber Barons/Captains of Industry, Technological Innovations, Transportation, Urbanization, Voter Turnout, and Xenophobia.https://repository.stcloudstate.edu/gilded_age/1001/thumbnail.jp

    Test-retest reliability and effects of repeated testing and satiety on performance of an Emotional Test Battery

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    The P1vital® Oxford Emotional Test Battery (ETB) comprises five computerized tasks designed to assess cognition and emotional processing in human participants. It has been used in between-subjects experimental designs; however, it is unclear whether the battery can be used in crossover designs. This is of particular importance given the increasing use of ETB tasks for repeated assessment of depressed patients in clinical trials and clinical practice. In addition, although satiety state has been reported to affect performance on some cognitive and emotional tasks, it is not known whether it can influence performance on the ETB. Two studies explored these issues. In Experiment 1, 30 healthy women were tested on the ETB on 4 separate occasions (each a week apart) in a within-subjects design. In Experiment 2, another 30 healthy women were randomized to either a satiated or a hungry condition, where they were given an ad libitum lunch of cheese sandwiches, before (satiated) or after (hungry) they were asked to complete the ETB. Experiment 1 demonstrated good test-retest reliability for the ETB. One of the tasks was free from practice effects, whilst performance on the other four tasks stabilized after the first two sessions. In Experiment 2, eating to satiety only affected performance on a single ETB task. These results suggest that the ETB can be used in crossover designs after two initial training sessions. Further, as a robust satiety manipulation had only a limited effect on a single ETB task, it is unlikely that appetitive state will confound ETB performance

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    Ability of the National Surgical Quality Improvement Program Risk Calculator to Predict Complications Following Total Laryngectomy

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    Importance The accuracy of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) risk calculator has been assessed in multiple surgical subspecialties; however, there have been no publications doing the same in the head and neck surgery literature. Objective To evaluate the accuracy of the calculator’s predictions in a single institution’s total laryngectomy (TL) population. Design, Setting, and Participants Total laryngectomies performed between 2013 and 2014 at a tertiary referral academic center were evaluated using the risk calculator. Predicted 30-day outcomes were compared with observed outcomes for return to operating room, surgical site infection, postoperative pneumonia, length of stay, and venous thromboembolism. Main Outcomes and Measures Comparison of the NSQIP risk calculator’s predicted postoperative complication rates and length of stay to what occurred in this patient cohort using percent error, Brier scores, area under the receiver operating characteristic curve, and Pearson correlation analysis. Results Of 49 patients undergoing TL, the mean (SD) age at operation was 59 (9.3) years, with 67% male. The risk calculator had limited efficacy predicting perioperative complications in this group of patients undergoing TL with or without free tissue reconstruction or preoperative chemoradiation or radiation therapy with a few exceptions. The calculator overestimated the occurrence of pneumonia by 165%, but underestimated surgical site infection by 7%, return to operating room by 24%, and length of stay by 13%. The calculator had good sensitivity and specificity of predicting surgical site infection for patients undergoing TL with free flap reconstruction (area under the curve, 0.83). For all other subgroups, however, the calculator had poor sensitivity and specificity for predicting complications. Conclusions and Relevance The risk calculator has limited utility for predicting perioperative complications in patients undergoing TL. This is likely due to the complexity of the treatment of patients with head and neck cancer and factors not taken into account when calculating a patient’s risk

    Regulating Transition‐Metal Catalysis through Interference by Short RNAs

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    Herein we report the discovery of a Au^I–DNA hybrid catalyst that is compatible with biological media and whose reactivity can be regulated by small complementary nucleic acid sequences. The development of this catalytic system was enabled by the discovery of a novel Au^I-mediated base pair. We found that Au^I binds DNA containing C-T mismatches. In the Au^I–DNA catalyst's latent state, the Au^I ion is sequestered by the mismatch such that it is coordinatively saturated, rendering it catalytically inactive. Upon addition of an RNA or DNA strand that is complementary to the latent catalyst's oligonucleotide backbone, catalytic activity is induced, leading to a sevenfold increase in the formation of a fluorescent product, forged through a Au^I-catalyzed hydroamination reaction. Further development of this catalytic system will expand not only the chemical space available to synthetic biological systems but also allow for temporal and spatial control of transition-metal catalysis through gene transcription
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