Librarians\u27 Lament

Our agenda is hidden from all but a few, Not one soul in a hundred has more than a clue. Not the man of the world or the sweet ingenue Has the foggiest notion of quite what we do

Relationship qualities that are associated with moments of relational depth: the client's perspective

This study explores the qualities of the therapeutic relationship that are associated with profound moments of interpersonal connectedness. Using a phenomenological approach, qualitative, semi-structured interviews were conducted with 14 participants all of whom had been clients of predominately person-centered counseling. Therapists with whom participants did experience moments of relational depth were experienced as being trustworthy, real, genuinely caring and earnest in their desire to understand. In relationships where they felt there was no moments of relational depth, participants described their therapist as distant, powerful, interpreting, misunderstanding or saying the right words but not really meaning it. Findings are discussed in relation to theory and previous studies, and suggestions for further research given

The concealed Caledonide basement of eastern England and the southern North Sea : a review

Field mapping, analysis of borehole core and studies of geophysical potential field and seismic data can be used to demonstrate the existence of a number of distinct crustal blocks within Eastern Avalonia beneath eastern England and the southern North Sea. At the core of these blocks is the Midlands Microcraton which is flanked by Ordovician volcanic arc complexes exposed in Wales and the Lake District. A possible volcanic arc complex of comparable age in eastern England is concealed by late Palaeozoic and Mesozoic cover. These volcanic arc complexes resulted from subduction of oceanic lithosphere beneath Avalonia prior to collision with Baltica and Laurentia in late Ordovician and Silurian time, respectively. The nature of the crust north and east of the concealed Caledonides of Eastern England and south of the lapetus Suture/Tornquist Sea Suture, which forms the basement to the southern North Sea, is unclear. Late Ordovician metamorphic ages from cores penetrating deformed metasedimentary rocks on the Mid-North Sea High suggest these rocks were involved in Avalonia-Baltica collision before final closure of the lapetus Ocean between Laurentia and Avalonia

Evidence for the continuum-severity model of psychosis through scrutiny of the architecture of symptoms associated with schizophrenia

The psychosis continuum provides a framework to develop a compelling insight into the architecture of psychotic experiences in non-clinical samples. Using schizophrenia specific measures within non-clinical samples offers further opportunity to investigate psychotic experiences and compare to those reported in clinical samples. A cross sectional survey method was used to collect data from a non-clinical sample (n=510) using the Schizophrenia Quality of Life Scale-Revision 4 (SQLS-R4) and the Hospital Anxiety and Depression Scale (HADS). Conducting confirmatory factor analysis and bi-factor modelling found that a bi-factor model offered a better model fit to the data than the established two factor model. A general factor explained most item variance whilst seven domain specific factors explained a further small amount of item variance. Participants with higher anxiety reported comparatively poorer QOL to those with lower anxiety. Comparison with data taken from a clinical sample found similarities in both the internal consistency and correlation coefficients between SQLS-R4 totals and sub-scales and HADS total scores and sub-scales. These results show the presence of a robust general psychosis QOL factor within a non-clinical sample. The use of schizophrenia specific measures and bi-factor modelling can provide suitable methods for investigating the nature of the psychosis continuum

Measurement properties of the Illness Perception Questionnaire in practitioners working with patients with co-morbid schizophrenia and learning disability

Rationale, aims and objectives: The widely-used Illness Perception Questionnaire (IPQ) adapted for use in patients with major mental health problems and those who care and work with them, was originally developed for evaluating the illness perceptions of patients with physical pathology. There have been concerns expressed regarding the appropriateness of the IPQ and derivative measures of it in axis I disorders such as schizophrenia. The current investigation examined the measurement characteristics of a modified version of the IPQ in mental health practitioners working with patients with schizophrenia co-morbid with learning disability. Method: Two hundred and ten mental health practitioners working with patients with schizophrenia co-morbid with learning disability participated in the study. Contemporary models of the measurement structure of the IPQ were evaluated using confirmatory factor analysis. The internal reliability of the IPQ was also evaluated. Results: Single factor, 5-factor and 6-factor models were evaluated against data. All models were found to offer a poor fit to the data. The internal reliability of the measure was also found to be unsatisfactory overall. Conclusions: Consistent with one previous study that has found poor measurement characteristics of the IPQ when used in the context of schizophrenia, the current study found the measure to be a poorly performing index of illness perceptions. Echoing previous observations of the use of this tool in axis I disorder, it is recommended that a new measure of illness perceptions be developed using contemporary research methodology sensitive to the context of psychotic illness in order to provide a more effective tool for the provision of person-centered psychiatry and healthcare

Health-Related Quality of Life (HRQoL) among Elderly Turkish and Polish Migrants and German Natives: The Role of Age, Gender, Income, Discrimination and Social Support

Background: Migration can negatively and positively influence health-related quality of life (HRQoL). Yet, little is known about the HRQoL of Turkish and Polish migrants and German natives

Exploratory study into the relationship between the symptoms of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and fibromyalgia (FM) using a quasiexperimental design

Objective To explore the relationship between symptoms of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and fibromyalgia (FM). The hypothesis predicated that there would be no significant differences between the group’s symptom experience.Design A quasiexperimental design. Structural equation modelling (SEM) and invariance testing.Participants Males (M) and females (F) >16 with a confirmed diagnosis of CFS/ME or FM by a general practitioner or specialist. CFS/ME (n=101, F: n=86, M: n=15, mean (M) age M=45.5 years). FM (n=107, F: n=95, M: n=12, M=47.2 years).Outcome measures Diagnostic criteria: the American Centers for Disease Control and Prevention (CDC) for CFS/ME and the American College of Rheumatology (ACR) criteria for FM. Additional symptom questionnaires measuring: pain, sleep quality, fatigue, quality of life, anxiety and depression, locus of control and self-esteem.Results Invariance was confirmed with the exception of the American CDC Symptom Inventory, Fibromyalgia Impact Questionnaire and Hospital Anxiety and Depression Scale (

Intraperitoneal photodynamic therapy causes a capillary-leak syndrome.

BackgroundIn patients undergoing intraperitoneal (IP) photodynamic therapy (PDT), the combination of aggressive surgical debulking and light therapy causes an apparent systemic capillary-leak syndrome that necessitates significant intensive care unit (ICU) management after surgery.MethodsFrom May 1997 to May 2001, 65 patients underwent surgical debulking and PDT as part of an ongoing phase II trial for disseminated IP cancer. Perioperative data were reviewed retrospectively, and statistical analyses were performed to determine whether any identifiable factors were associated with the need for mechanical ventilation for longer than 1 day and with the occurrence of postoperative complications.ResultsForty-three women and 22 men (mean age, 49 years) were treated. Operative time averaged 9.8 hours, and mean estimated blood loss was 1450 mL. The mean crystalloid requirement for the first 48 hours after surgery was 29.3 L, and 49 patients required blood products. Twenty-four patients were intubated for longer than 24 hours, with a mean of 8.3 days for those intubated longer than 1 day. The median ICU stay was 4 days. Overall, 110 complications developed in 45 (69%) of the 65 patients. Significant complications included 6 patients with acute respiratory distress syndrome, 28 patients with infectious complications, and 4 patients with anastomotic complications. Statistical analyses revealed that surgery-related factors were significantly associated with these complication outcomes.ConclusionsPatients who undergo surgical debulking and IP PDT develop a significant capillary-leak syndrome after surgery that necessitates massive volume resuscitation, careful ICU monitoring, and, frequently, prolonged ventilatory support