Outcomes of a 5-week individualised MDT outpatient (day-patient) treatment programme for functional neurological symptom disorder (FNSD)

AIM: We report results from a 5-week MDT treatment programme, with individualised sessions, for a selected group of patients with FNSD, delivered in a neuropsychiatric outpatient setting. Primary aims were to (1) reduce symptoms, (2) improve functional performance and (3) improve health status. METHODS: Treatment involved individual sessions of neuropsychiatry, cognitive behavioural therapy, physiotherapy, occupational-therapy, education and family meetings. Outcome measures collected at the beginning and end of treatment and at 6 months, were patient and clinician reported. Aims were assessed by the following: symptom reduction (PHQ15, PHQ9, GAD7, SPIN, Rosenberg); health and social functioning (HONOS, WSAS); functional performance (COPM); health status (EQ-5D-5L) and patient-rated perception of improvement (CGI). RESULTS: Analyses of 78 patients completing the programme and attending a 6-month review revealed high-baseline levels of disability compared to EQ-5DL population norms and high rates of disability and psychopathology as indicated by the WSAS and mental health indices (PHQ9, GAD7, SPIN, Rosenberg's self-esteem). At baseline, 92.3% met the IAPT caseness threshold for depression and 71% met the IAPT caseness threshold for anxiety. A Friedman ANOVA over the three time points and Dunn-Bonferroni post hoc tests indicated statistically significant improvements from admission to discharge and admission to 6-month follow-up. Sustained improvements were seen in somatic symptoms (PHQ15), depression (PHQ9), anxiety (GAD7), health and social functioning (HONOS), functionality (COPM), health status (EQ-5D-5L) and patient-rated clinical global improvement (CGI). CONCLUSION: An MDT can effectively deliver an outpatient programme for FNSD which can serve as an alternative to costlier inpatient programmes. Early identification and treatment of co-morbidities is advised

KOMPOSISI WARNA WEBSITE UNIVERSITAS KELAS DUNIA, STUDI KASUS HARVARD UNIVERSITY, UNIVERSITY OF CAMBRIDGE DAN NATIONAL TAIWAN UNIVERSITY

Warna sangat besar pengaruh dalam kehidupan manusia sehari – hari, baik dalam dunia seni lukis, media masa cetak, desain interior, presentasi, dunia politik dan tentunya juga pada desain web. Warna merupakan sebuah bidang yang menarik untuk dikaji karena warna mempengaruhi psikologis,  kognitif, rasa dan warna memberikan identitas pada setiap obyek yang dilekatinya. Komposisi warna bisa diibaratkan dua sisi mata pisau, bila tepat mengkombinasikannya maka akan memberikesan positif dan apabila salah dalam mengkombinasikan maka akan memberikan kesan negatif kepada orang yang melihatnya. Pada penelitian ini penulis akan menganalisis komposisi warna pada website universitas kelas dunia (Harvard University, University Of Cambridge, National Taiwan University) dan mencoba menerjemahkan arti dibalik warna website tersebut berdasarkan teori warna budaya barat

KOMPOSISI WARNA WEBSITE UNIVERSITAS KELAS DUNIA, STUDI KASUS HARVARD UNIVERSITY, UNIVERSITY OF CAMBRIDGE DAN NATIONAL TAIWAN UNIVERSITY

Warna sangat besar pengaruh dalam kehidupan manusia sehari – hari, baik dalam dunia seni lukis, media masa cetak, desain interior, presentasi, dunia politik dan tentunya juga pada desain web. Warna merupakan sebuah bidang yang menarik untuk dikaji karena warna mempengaruhi psikologis,  kognitif, rasa dan warna memberikan identitas pada setiap obyek yang dilekatinya. Komposisi warna bisa diibaratkan dua sisi mata pisau, bila tepat mengkombinasikannya maka akan memberikesan positif dan apabila salah dalam mengkombinasikan maka akan memberikan kesan negatif kepada orang yang melihatnya. Pada penelitian ini penulis akan menganalisis komposisi warna pada website universitas kelas dunia (Harvard University, University Of Cambridge, National Taiwan University) dan mencoba menerjemahkan arti dibalik warna website tersebut berdasarkan teori warna budaya barat

Asuhan Kebidanan Berkesinambungan pada Ny.W Usia 29 TahunG2P1AB0AH1 dengan Kehamilan Normal di Wilayah Puskesmas Minggir Sleman

Kehamilan merupakan hal yang fisiologis bagi semua wanita yang berada pada reproduksi sehat, tetapi tidak semua kehamilan normal tanpa penyulit, sehingga muncul paradigma baru untuk mensejahterakan kesehatan ibu dan anak. Upaya dalam mensejahterakan kesehatan ibu dan anak adalah dengan cara melakukan asuhan berkesinambungan (Contiunty of Care) sebagai tindakan preventif dan deteksi dini dalam upaya penanganan komplikasi maternal yang mungkin terjadi baik pada saat kehamilan hingga proses nifas. Pada kasus ini dilakukan pendampingan dari mulai ibu hamil trimester III hingga keluarga berencana. Hal ini efektif karena bisa mendekteksi komplikasi sejak dini. Komunikasi yang efektif juga dapat terjalin dengan baik. Pada kehamilan trimester III ditemukan kecemasan menjelang persalinan. Proses persalinan berlangsung normal walapun pada awal ke Puskesmas sempat panik karena pembukaan sudah lengkap. Bayi baru lahir sehat dan tidak ada penyulit selama kunjungan neonatal. Pada masa nifas keadaan klien baik. Kesimpulan pada laporan ini adalah kunjungan hamil, nifas, bayi baru lahir, dan neonatal, serta konseling Keluarga Berencana (KB) di lakukan sesuai flow chart asuhan berkesinambungan dan berdasarkan jawal kunjungan. Beberapa penatalaksanaan dilakukan dan dievaluasi dengan hasil baik tetapi ada kasus yang lost of control karena kegagalan pemberian asuhan berkesinambungan contohnya pada pendampingan keluarga berencana

The use of mesenchymal stromal cells in treatment of lung disorders

The therapeutic use of mesenchymal stromal cells (MSCs) represents a promising alternative clinical strategy for treating acute and chronic lung disorders. Several pre-clinical reports demonstrated that MSCs can secrete multiple paracrine factors and that their immunomodulatory properties can support endothelial and epithelial regeneration, modulate the inflammatory cascade, and protect lungs from damage. The effects of MSC transplantation into patients suffering from lung diseases should be fully evaluated through careful assessment of safety and associated risks, which is a prerequisite for translation of pre-clinical research into clinical practise. In this article we summarise the current status of pre-clinical research and review initial MSC-based clinical trials for treating lung injuries and lung disorders

FEM Simulation of Non-Progressive Growth from Asymmetric Loading and Vicious Cycle Theory: Scoliosis Study Proof of Concept

Scoliosis affects about 1-3% of the adolescent population, with 80% of cases being idiopathic. There is currently a lack of understanding regarding the biomechanics of scoliosis, current treatment methods can be further improved with a greater understanding of scoliosis growth patterns. The objective of this study is to develop a finite element model that can respond to loads in a similar fashion as current spine biomechanics models and apply it to scoliosis growth. Using CT images of a non-scoliotic individual, a finite element model of the L3-L4 vertebra was created. By applying asymmetric loading in accordance to the ‘vicious cycle’ theory and through the use of a growth modulation equation it is possible to determine the amount of growth each region of the vertebra will undergo; therefore predict scoliosis growth over a period of time. This study seeks to demonstrate how improved anatomy can expand researchers current knowledge of scoliosis

Oxidative Stress Impairs the Heat Stress Response and Delays Unfolded Protein Recovery

Background: Environmental changes, air pollution and ozone depletion are increasing oxidative stress, and global warming threatens health by heat stress. We now face a high risk of simultaneous exposure to heat and oxidative stress. However, there have been few studies investigating their combined adverse effects on cell viability. Principal Findings: Pretreatment of hydrogen peroxide (H2O2) specifically and highly sensitized cells to heat stress, and enhanced loss of mitochondrial membrane potential. H 2O 2 exposure impaired the HSP40/HSP70 induction as heat shock response (HSR) and the unfolded protein recovery, and enhanced eIF2a phosphorylation and/or XBP1 splicing, land marks of ER stress. These H2O2-mediated effects mimicked enhanced heat sensitivity in HSF1 knockdown or knockout cells. Importantly, thermal preconditioning blocked H 2O 2–mediated inhibitory effects on refolding activity and rescued HSF1 +/+ MEFs, but neither blocked the effects nor rescued HSF1-/- MEFs. These data strongly suggest that inhibition of HSR and refolding activity is crucial for H2O2–mediated enhanced heat sensitivity. Conclusions: H2O2 blocks HSR and refolding activity under heat stress, thereby leading to insufficient quality control and enhancing ER stress. These uncontrolled stress responses may enhance cell death. Our data thus highlight oxidative stres

Germline variation at 8q24 and prostate cancer risk in men of European ancestry

An Author Correction to this article was published on 17 January 2019.Chromosome 8q24 is a susceptibility locus for multiple cancers, including prostate cancer. Here we combine genetic data across the 8q24 susceptibility region from 71,535 prostate cancer cases and 52,935 controls of European ancestry to define the overall contribution of germline variation at 8q24 to prostate cancer risk. We identify 12 independent risk signals for prostate cancer (p < 4.28 × 10 −15 ), including three risk variants that have yet to be reported. From a polygenic risk score (PRS) model, derived to assess the cumulative effect of risk variants at 8q24, men in the top 1% of the PRS have a 4-fold (95%CI = 3.62–4.40) greater risk compared to the population average. These 12 variants account for ~25% of what can be currently explained of the familial risk of prostate cancer by known genetic risk factors. These findings highlight the overwhelming contribution of germline variation at 8q24 on prostate cancer risk which has implications for population risk stratification. © 2018, The Author(s).Chromosome 8q24 is a susceptibility locus for multiple cancers, including prostate cancer. Here we combine genetic data across the 8q24 susceptibility region from 71,535 prostate cancer cases and 52,935 controls of European ancestry to define the overall contribution of germline variation at 8q24 to prostate cancer risk. We identify 12 independent risk signals for prostate cancer (p < 4.28 × 10 −15 ), including three risk variants that have yet to be reported. From a polygenic risk score (PRS) model, derived to assess the cumulative effect of risk variants at 8q24, men in the top 1% of the PRS have a 4-fold (95%CI = 3.62–4.40) greater risk compared to the population average. These 12 variants account for ~25% of what can be currently explained of the familial risk of prostate cancer by known genetic risk factors. These findings highlight the overwhelming contribution of germline variation at 8q24 on prostate cancer risk which has implications for population risk stratification. © 2018, The Author(s).Peer reviewe