The effects of a mindfulness-based family psychoeducation intervention for the caregivers of young adults with first-episode psychosis: A randomized controlled trial

Objective: In this study, we investigated the effects of a mindfulness-based family psychoeducation (MBFPE) program on the mental-health outcomes of both caregivers and young adults with first-episode psychosis with an onset in the past three years through a multi-site randomized controlled trial. We also studied the outcomes of three potential mediating effects of interpersonal mindfulness, expressed emotions, and non-attachment on the program. Method: We randomly assigned 65 caregivers of young adults with psychosis to MBFPE (n = 33) or an ordinary family psychoeducation (FPE) program (n = 32); among them, 18 young adults in recovery also participated in the evaluation of outcomes. Results: Intent-to-treat analyses were conducted. No significant time × group interaction effects of MBFPE and FPE programs were found in any of the caregivers’ outcomes. However, the young adults with psychosis reported higher levels of recovery after the MBFPE program than after the ordinary FPE program (F = 8.268, p = 0.012, d = 1.484). They also reported a larger reduction in over-involvement of their caregivers (F = 4.846, p = 0.044, d = 1.136), showing that MBFPE had a superior effect to FPE in promoting recovery and reducing over-involvement. Conclusions: A brief psychoeducation program may not reduce the burden on or improve the mental-health outcome of caregivers of individuals with recent-onset psychosis. However, integrating mindfulness into a conventional family psychoeducation program may reduce the expressed emotions of caregivers, especially over-involvement. Further studies should explore how psychoeducation programs can reduce the impact of psychosis on family through sustainable effects in terms of reducing their burden and expressed emotions, using a rigorous study and adequate sample size

Representational predicaments for employees: Their impact on perceptions of supervisors\u27 individualized consideration and on employee job satisfaction

A representational predicament for a subordinate vis-à-vis his or her immediate superior involves perceptual incongruence with the superior about the subordinate\u27s work or work context, with unfavourable implications for the employee. An instrument to measure the incidence of two types of representational predicament, being neglected and negative slanting, was developed and then validated through an initial survey of 327 employees. A subsequent substantive survey with a fresh sample of 330 employees largely supported a conceptual model linking being neglected and negative slanting to perceptions of low individualized consideration by superiors and to low overall job satisfaction. The respondents in both surveys were all Hong Kong Chinese. Two case examples drawn from qualitative interviews illustrate and support the conceptual model. Based on the research findings, we recommend some practical exercises to use in training interventions with leaders and subordinates. © 2013 Copyright Taylor and Francis Group, LLC

Leveraging social networks to gain access to organisational resources

We describe a federated identity management service that allows users to access organisational resources using their existing login accounts at social networking and other sites, without compromising the security of the organisation’s resources. We utilise and extend the Level of Assurance (LoA) concept to ensure the organisation’s site remains secure. Users are empowered to link together their various accounts, including their organizational one with an external one, so that the strongest registration procedure of one linked account can be leveraged by the other sites’ login processes that have less stringent registration procedures. Coupled with attribute release from their organizational account, this allows users to escalate their privileges due to either an increased LoA, or additional attributes, or both. The conceptual and architectural designs are described, followed by the implementation details, the user trials we carried out, and a discussion of the current limitations of the system

Validation of a modified early warning score (MEWS) in emergency department observation ward patients

The Modified Early Warning Score (MEWS) is a simple physiological scoring system, which can easily be applied at the bedside. The ability of MEWS to identify patients at risk of deterioration in a busy ward was investigated. Method: In a prospective cohort study, we applied MEWS to patients admitted to the 16-bed emergency department observation ward (EDOW) of a tertiary teaching hospital. Results: Data on 427 consecutive EDOW admissions were collected from 7 June to 4 July 2004. Main outcome measures were death, intensive care unit (ICU) admission and inpatient hospital admission. Scores of > 4 were associated with increased risk of death (OR 54.4, 95% CI = 4.7−633.7), ICU admission (OR 12.7, 95% CI = 1.1−147.3) and hospital admission (OR 9.5, 95% CI = 3.3−27.9). Conclusion: MEWS is suitable for bedside application in an EDOW setting and may help identify patients at risk of deterioration who require increased levels of care as hospital inpatients and in ICU. Where experienced staff is not available to closely monitor patients in an EDOW, the use of the MEWS system may aid close monitoring and identification of high-risk patients

Validation of a modified early warning score (MEWS) in emergency department observation ward patients

The Modified Early Warning Score (MEWS) is a simple physiological scoring system, which can easily be applied at the bedside. The ability of MEWS to identify patients at risk of deterioration in a busy ward was investigated. Method: In a prospective cohort study, we applied MEWS to patients admitted to the 16-bed emergency department observation ward (EDOW) of a tertiary teaching hospital. Results: Data on 427 consecutive EDOW admissions were collected from 7 June to 4 July 2004. Main outcome measures were death, intensive care unit (ICU) admission and inpatient hospital admission. Scores of > 4 were associated with increased risk of death (OR 54.4, 95% CI = 4.7−633.7), ICU admission (OR 12.7, 95% CI = 1.1−147.3) and hospital admission (OR 9.5, 95% CI = 3.3−27.9). Conclusion: MEWS is suitable for bedside application in an EDOW setting and may help identify patients at risk of deterioration who require increased levels of care as hospital inpatients and in ICU. Where experienced staff is not available to closely monitor patients in an EDOW, the use of the MEWS system may aid close monitoring and identification of high-risk patients

Circulating Epstein-Barr virus DNA in serum of patients with lymphoepithelioma-like carcinoma of the lung: A potential surrogate marker for monitoring disease

Purpose: The purpose of this work was to study the sera of patients with lymphoepithelioma-like carcinoma (LELC) of the lung for circulating EBV DNA. Experimental Design: Prospectively collected serum samples from five female patients with advanced, inoperable LELC of the lung were measured for free circulating EBV DNA using a quantitative PCR technique. EBV-encoded small RNA (EBER)-1 was assayed in serial serum samples of three of the rive patients, either from the start or during the initial phase of chemotherapy/radiotherapy until their terminal event or last follow-up. There was only a single-point sample for analysis in the fourth and fifth patients. Six other patients with LELC of the lung were also retrospectively identified, and their sera were tested for EBER-1 at either the first visit plus the last follow-up visit (n = 2), the first visit only (n = 2), or the last follow-up visit only (n = 2). Results: Prospectively collected serum samples from five patients and retrospectively collected serum samples from two patients who had clinical disease at initial serum measurement showed detectable levels of EBER-1. Retrospectively collected serum samples from four patients with no clinical disease had negative sera. There is consistent correlation between the clinical response to treatment and subsequent clinical course of LELC and serum EBER-1 levels in the three prospective patients with longitudinal serum monitoring. Conclusions: This study shows for the first time that free EBV DNA can be detected in the serum of patients with LELC of the lung and further suggests the feasibility of its use for monitoring response to therapy in advanced cases.Link_to_subscribed_fulltex

In vitro vitamin K2 and 1α,25-dihydroxyvitamin D3 combination enhances osteoblasts anabolism of diabetic mice

In this study, we evaluated the anabolic effect and the underlying cellular mechanisms involved of vitamin K2 (10 nM) and 1α,25-dihydroxyvitamin D3 (1,25(OH)2D3) (10 nM), alone and in combination, on primary osteoblasts harvested from the iliac crests of C57BL/KsJ lean (+/+) and obese/diabetic (db/db) mice. A lower alkaline phosphatase (ALP) activity plus a reduced expression of bone anabolic markers and bone formation transcription factors (osteocalcin, Runx2, Dlx5, ATF4 and OSX) were consistently detected in osteoblasts of db/db mice compared to lean mice. A significantly higher calcium deposits formation in osteoblasts was observed in lean mice when compared to db/db mice. Co-administration of vitamin K2 (10 nM) and 1,25(OH)2D3 (10 nM) caused an enhancement of calcium deposits in osteoblasts in both strains of mice. Vitamins K2 and 1,25(OH)2D3 co-administration time-dependently (7, 14 and 21 days) increased the levels of bone anabolic markers and bone formation transcription factors, with a greater magnitude of increase observed in osteoblasts of db/db mice. Combined vitamins K2 plus 1,25(OH)2D3 treatment significantly enhanced migration and the re-appearance of surface microvilli and ruffles of osteoblasts of db/db mice. Thus, our results illustrate that vitamins K2 plus D3 combination could be a novel therapeutic strategy in treating diabetes-associated osteoporosis