Pflegepersonal nach Patientengewalt in der Akutpsychiatrie: psychische Folgen und Unterstützungsmassnahmen : eine Literaturübersicht

Gewaltereignisse können in psychiatrischen Akutstationen nicht immer vermieden werden. Pflegende sind unter allen Gesundheitsberufen am häufigsten von Gewalt betroffen, welche überwiegend von Patienten ausgeht. Bisher wurde vorwiegend physischen Folgen von Patientengewalt Aufmerksamkeit geschenkt. Welche psychi-schen Folgen bei Pflegepersonal auftreten können und wie mögliche Unterstützung aus-sehen könnte, wurde weniger thematisiert

Quantifying the effect of genetic, environmental and individual demographic stochastic variability for population dynamics in Plantago lanceolata

Simple demographic events, the survival and reproduction of individuals, drive population dynamics. These demographic events are influenced by genetic and environmental parameters, and are the focus of many evolutionary and ecological investigations that aim to predict and understand population change. However, such a focus often neglects the stochastic events that individuals experience throughout their lives. These stochastic events also influence survival and reproduction and thereby evolutionary and ecological dynamics. Here, we illustrate the influence of such non-selective demographic variability on population dynamics using population projection models of an experimental population of Plantago lanceolata. Our analysis shows that the variability in survival and reproduction among individuals is largely due to demographic stochastic variation with only modest effects of differences in environment, genes, and their interaction. Common expectations of population growth, based on expected lifetime reproduction and generation time, can be misleading when demographic stochastic variation is large. Large demographic stochastic variation exhibited within genotypes can lower population growth and slow evolutionary adaptive dynamics. Our results accompany recent investigations that call for more focus on stochastic variation in fitness components, such as survival, reproduction, and functional traits, rather than dismissal of this variation as uninformative noise

Using automated pharmacy records to assess the management of tuberculosis.

We used automated pharmacy dispensing data to characterize tuberculosis (TB) management for 45 health maintenance organization (HMO) members. Pharmacy records distinguished patients treated in HMOs from those treated elsewhere. For cases treated in HMOs, they provided useful information about appropriateness of prescribed regimens and adherence to therapy

The Radioecology Exchange

The Radioecology Exchange (www.radioecology-exchange.org) was created in 2011 under the EU FP7 STAR (STrategy for Allied Radioecology, www.star-radioecology.org) Network of Excellence; (2011-2015). This project aims to integrate radioecological research efforts of European organisations into a sustainable network. In 2013, the EU FP7 COMET (COordination and iMplementation of a pan-European instrumenT for radioecology (2013- 2017); www.comet-radioecology.org) project commenced; COMET will build upon the work initiated under STAR. The Radioecology Exchange has therefore become the web resource for activities from both projects which will ultimately be maintained by the European Radioecology Alliance (ALLIANCE; www.er-alliance.org). The Radioecology Exchange is intended to become a ‘gateway’ for information related to European (and wider) radioecological research

Towards a standardized nutrition and dietetics terminology for clinical practice:An Austrian multicenter clinical documentation analysis based on the International Classification of Functioning, Disability and Health (ICF)-Dietetics

Background High quality, continuity and safe interdisciplinary healthcare is essential. Nutrition and dietetics plays an important part within the interdisciplinary team in many health conditions. In order to work more effectively as an interdisciplinary team, a common terminology is needed. This study investigates which categories of the ICF-Dietetics are used in clinical dietetic care records in Austria and which are most relevant to shared language in different medical areas. Method A national multicenter retrospective study was conducted to collect clinical dietetic care documentation reports. The analysis included the “best fit” framework synthesis, and a mapping exercise using the ICF Linking Rules. Medical diagnosis and intervention concepts were excluded from the mapping, since they are not supposed to be classified by the ICF. Results From 100 dietetic records, 307 concepts from 1807 quotations were extracted. Of these, 241 assessment, dietetics diagnosis, goal setting and evaluation concepts were linked to 153 ICF-Dietetics categories. The majority (91.3%) could be mapped to a precise ICF-Dietetics category. The highest number of ICF-Dietetics categories was found in the medical area of diabetes and metabolism and belonged to the ICF component Body Function, while very few categories were used from the component Participation and Environmental Factors. Conclusions The integration of the ICF-Dietetics in nutrition and dietetic care process is possible. Moreover, it could be considered as a conceptual framework for interdisciplinary nutrition and dietetics care. However, a successful implementation of the ICF-Dietetics in clinical practice requires a paradigm shift from medical diagnosis-focused health care to a holistic perspective of functioning with more attention on Participation and Environmental Factors.(VLID)489878

The art of indigeneity: Aesthetics and competition in Mexican economies of culture

On the basis of ethnographic research with woodcarvers in Oaxaca, Mexico, this paper investigates the role that aesthetic practices play in economic competition in cultural markets. I explain how one family has become the most successful artisans in their village by aesthetically referencing the indigenous art that is highly sought after by the North American ethnic art market. By reformulating Bourdieu's analysis of artistic fields, I argue that aesthetic competition should be theorised at the level of genres, which allow insight into how individual aesthetic innovations may transform the fields in which art is produced and circulated. I show that by referencing indigeneity, this successful family not only accesses a new market but also renders their work more authoritative than the carvings of their neighbours, which aesthetically reference Mexican ‘artesanías’ (craftwork). In so doing, they not only earn more money but also change the ways that Oaxacan woodcarvings are valued in general

Effect of natalizumab on disease progression in secondary progressive multiple sclerosis (ASCEND). a phase 3, randomised, double-blind, placebo-controlled trial with an open-label extension

Background: Although several disease-modifying treatments are available for relapsing multiple sclerosis, treatment effects have been more modest in progressive multiple sclerosis and have been observed particularly in actively relapsing subgroups or those with lesion activity on imaging. We sought to assess whether natalizumab slows disease progression in secondary progressive multiple sclerosis, independent of relapses. Methods: ASCEND was a phase 3, randomised, double-blind, placebo-controlled trial (part 1) with an optional 2 year open-label extension (part 2). Enrolled patients aged 18–58 years were natalizumab-naive and had secondary progressive multiple sclerosis for 2 years or more, disability progression unrelated to relapses in the previous year, and Expanded Disability Status Scale (EDSS) scores of 3·0–6·5. In part 1, patients from 163 sites in 17 countries were randomly assigned (1:1) to receive 300 mg intravenous natalizumab or placebo every 4 weeks for 2 years. Patients were stratified by site and by EDSS score (3·0–5·5 vs 6·0–6·5). Patients completing part 1 could enrol in part 2, in which all patients received natalizumab every 4 weeks until the end of the study. Throughout both parts, patients and staff were masked to the treatment received in part 1. The primary outcome in part 1 was the proportion of patients with sustained disability progression, assessed by one or more of three measures: the EDSS, Timed 25-Foot Walk (T25FW), and 9-Hole Peg Test (9HPT). The primary outcome in part 2 was the incidence of adverse events and serious adverse events. Efficacy and safety analyses were done in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01416181. Findings: Between Sept 13, 2011, and July 16, 2015, 889 patients were randomly assigned (n=440 to the natalizumab group, n=449 to the placebo group). In part 1, 195 (44%) of 439 natalizumab-treated patients and 214 (48%) of 448 placebo-treated patients had confirmed disability progression (odds ratio [OR] 0·86; 95% CI 0·66–1·13; p=0·287). No treatment effect was observed on the EDSS (OR 1·06, 95% CI 0·74–1·53; nominal p=0·753) or the T25FW (0·98, 0·74–1·30; nominal p=0·914) components of the primary outcome. However, natalizumab treatment reduced 9HPT progression (OR 0·56, 95% CI 0·40–0·80; nominal p=0·001). In part 1, 100 (22%) placebo-treated and 90 (20%) natalizumab-treated patients had serious adverse events. In part 2, 291 natalizumab-continuing patients and 274 natalizumab-naive patients received natalizumab (median follow-up 160 weeks [range 108–221]). Serious adverse events occurred in 39 (13%) patients continuing natalizumab and in 24 (9%) patients initiating natalizumab. Two deaths occurred in part 1, neither of which was considered related to study treatment. No progressive multifocal leukoencephalopathy occurred. Interpretation: Natalizumab treatment for secondary progressive multiple sclerosis did not reduce progression on the primary multicomponent disability endpoint in part 1, but it did reduce progression on its upper-limb component. Longer-term trials are needed to assess whether treatment of secondary progressive multiple sclerosis might produce benefits on additional disability components. Funding: Biogen