Challenges encountered by frontline professionals in care for adolescents who self-harm. A qualitative study conducted on an inpatient unit implementing Adolescent Mentalization-Based Integrative Treatment (AMBIT)

Research: The prevalence rate of self-harm among adolescents is high and rising. This is a worrying trend, considering that self-harm is associated with poor mental health and an increased risk of suicide. However, research literature suggests that adolescents rarely seek help and that caring for them is a complex task. Furthermore, the existing research indicates that healthcare professionals’ views and responses to working with this patient group may be influenced by interplay of individual, interpersonal and institutional processes. Those working on the frontline in inpatient settings seem to be most affected by these processes. It was proposed that to support frontline healthcare professionals in caring for this patient group theory-driven therapeutic models need to be developed. It was also proposed that psychoanalytic theories were best positioned to manage the impact of the processes posing challenges to care for adolescents who self-harm. Research aims: This thesis aimed to investigate the challenges experienced by frontline professionals caring for adolescent patients who self-harmed whilst being treated on an inpatient unit, and frontline professionals responses to these challenges, including their use of Adolescent Mentalization-Based Integrative Treatment (AMBIT), a psychodynamically-oriented approach to care for adolescents with complex needs. Method: Qualitative methods were employed in this study. Twelve participants were recruited from an adolescent inpatient unit implementing AMBIT. Data were generated with semi-structured interviews and analysed with descriptive inductive thematic analysis. Findings: Four overarching themes were generated. The first three themes informed on the challenges in care for adolescent patients associated with patients’ and frontline professionals’ unhelpful relationships on the unit; and the impact of frontline team professionals’ responses to self-harm on their practices. The fourth theme elucidated frontline professionals’ use of AMBIT. Discussion: The findings provided new insights into the processes influencing frontline professionals’ work with adolescent patients who self-harmed whilst being treated on an inpatient unit. The opportunities and challenges related to the frontline professionals’ use of AMBIT were discussed

Violence against old people : a review of the literature

The authors reviewed available literature on the phenomenon of the elderly people abuse. In connection with ongoing worldwide demographic changes, a rapid growth of the population aged 60 years and more is noted. Such trends will continue, which gives rise to a gradual increase in the number of cases of abused seniors. The article presents definitions of violence against elderly people, with a special emphasis on the symptoms that may suggest abuse. Furthermore, we specified the articles that focus on the assessment of individual risk factors that may increase the occurrence of aggressive behaviour towards seniors. We also focused on analysis of available literature on the prevalence of violence against the elderly, both in Poland and worldwide. Analysis of the data from countries with different structural and cultural conditions clearly confirms the presence of this phenomenon everywhere, although it appears to varying extent. Research results depend on many factors, including the applied research methodology and measurement tools, the accepted definition of violence and sources of information. Worth noting are underestimated statistics which may be due to senior citizens’ reluctance to disclose abuses. In view of the multidimensional nature of the issue, it is important to introduce further system solutions in order to reduce the incidence of elderly people abuse and more effectively detect and resolve the problem, which still constitutes, especially in our country, a taboo subject.Autorzy dokonali przeglądu dostępnego piśmiennictwa na temat zjawiska przemocy wobec osób starszych. W związku z zachodzącymi na całym świecie zmianami demograficznymi następuje szybki wzrost populacji osób w wieku 60 lat i starszych. Takie tendencje będą się utrzymywać, co niesie ze sobą stopniowy wzrost liczby przypadków znęcania się nad seniorami. W artykule przedstawiono definicje przemocy wobec osób starszych oraz opisano główne rodzaje stosowanej przemocy, ze szczególnym uwzględnieniem symptomów sugerujących nadużycia. Ponadto wyszczególniono prace koncentrujące się na ocenie czynników ryzyka, które mogą zwiększyć występowanie zachowań agresywnych wobec seniorów. Autorzy skupili się również na analizie dostępnej literatury na temat rozpowszechnienia zjawiska przemocy wobec osób starszych, zarówno w Polsce, jak i na świecie. Analiza danych z krajów o zróżnicowanych uwarunkowaniach strukturalnych i kulturowych jednoznacznie potwierdza obecność tego zjawiska wszędzie, jakkolwiek występuje ono z różnym nasileniem. Rezultaty badań zależą od wielu czynników, m.in. Od zastosowanej metodologii badań i narzędzi pomiaru, przyjętej definicji przemocy czy też źródła informacji. Uwagę zwracają zaniżone statystyki, które mogą być spowodowane niechęcią samych seniorów do ujawniania nadużyć. W związku z wielowymiarowym charakterem zagadnienia ważne jest dalsze wprowadzanie rozwiązań systemowych, celem ograniczenia zjawiska przemocy wobec osób starszych oraz skuteczniejszego wykrywania i rozwiązywania problemu, stanowiącego nadal, zwłaszcza w naszym kraju, temat tabu

Nanoparticles of copper stimulate angiogenesis at systemic and molecular level

Copper is a key element affecting blood vessel growth and muscle development. However, the ions released from Cu salts are toxic. Given their specific physicochemical properties, nanoparticles of Cu (NanoCu) may have different bioactivity and affect the development of blood vessel and muscles in a different manner than Cu salts. The objective of the study was to evaluate the influence of NanoCu on embryo development and angiogenesis at the systemic and molecular level, in experiments using a chick embryo model. Fertilized chicken eggs were divided into a control group, and groups injected with a placebo, CuSO4 or NanoCu. Embryo development at the whole body level and molecular indices using an embryo chorioallantoic membrane model were measured during embryogenesis. The present study indicated for the first time that NanoCu have pro-angiogenic properties at the systemic level, to a greater degree than CuSO4 salt. The properties of NanoCu were confirmed at the molecular level, demonstrating significant effects on mRNA concentration and on mRNA gene expression of all pro-angiogenic and pro-proliferative genes measured herein

Psoriasis and menopause : part I : impact of psoriasis on quality of life in women in peri- and postmenopausal age

Niniejszy artykuł stanowi przegląd piśmiennictwa medycznego na temat wpływu przewlekłej choroby skóry, jaką jest łuszczyca, na jakość życia u kobiet w wieku około- i pomenopauzalnym. W badaniach poświęconych tej kwestii pojawia się coraz więcej doniesień dotyczących istnienia zależności pomiędzy zaawansowaniem zmian skórnych a stanem psychicznym pacjentek w okresie klimakterium. Autorzy publikacji podkreślają zasadność holistycznego spojrzenia na pacjenta z uwzględnieniem jego potrzeb zarówno na poziomie biologicznym, jak i psychologicznym. Wszystkie te kwestie wydają się bowiem istotne dla poprawy jakości życia kobiet w wieku okołomenopauzalnym ze współwystępującą łuszczycą.This article is a review of medical literature on the effects of chronic skin disease that is psoriasis on the quality of life in women in peri- and postmenopausal age. In studies on this issue there is a growing literature about the existence of the relationship between the severity of skin lesions and mental state of women during menopause. Authors emphasize the legitimacy of a holistic approach to the patient, taking into account their needs at both the biological and psychological levels. All these issues seem to be vital for improving the quality of life in perimenopausal women with co-occurring psoriasis

Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P\ua0 64 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF 6445%