Efficacy of shared decision making on treatment satisfaction for patients with first-admission schizophrenia: study protocol for a randomised controlled trial

BACKGROUND: Shared decision making is a promising model for patient-centred medicine, resulting in better clinical outcomes overall. In the mental health field, interventions that consider the patient-centred perspective—such as patient quality of life, involvement in the treatment, treatment satisfaction, and working alliance—have increased and better clinical outcomes discovered for patients with schizophrenia. However, few studies have examined the efficacy of shared decision making for schizophrenia treatment. The objective of this study is to evaluate the effect of a shared decision making intervention compared to treatment as usual on patient satisfaction at discharge for first-admission patients with schizophrenia. METHODS/DESIGN: This is a randomised, parallel-group, two-arm, open-label, single-centre study currently being conducted in an acute psychiatric ward of Numazu Chuo Hospital, Japan. We are recruiting patients between 16 and 65 years old who are admitted to the ward with a diagnosis of schizophrenia without prior experience of psychiatric admission. Fifty-eight participants are being randomised into a shared decision making intervention group or a treatment as usual control group in a 1:1 ratio. The intervention program was developed based on a shared decision making model and is presented as a weekly course lasting the duration of the patients’ acute psychiatric ward stay. The primary outcome measure is patient satisfaction at discharge as assessed by the Client Satisfaction Questionnaire. Due to the study’s nature, neither the patient nor staff can be blinded. DISCUSSION: This is the first randomised controlled trial to evaluate the efficacy of shared decision making for patients with early-treatment-stage schizophrenia. The intervention program in this study is innovative in that it includes both of the patient and staff who are involved in the treatment. TRIAL REGISTRATION: The study has been registered with ClinicalTrials.gov as NCT01869660

Influence of patient characteristics on duration of seclusion/restrain in acute psychiatric settings in Japan

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Strain dependent differences in a quantitative histological study and expression analysis in irradiated murine lung

Although clinical observation can often reveal individual differences in the severity of lung fibrosis after radiation therapy, the actual influences of inherent individual factor is difficult to determine a clinical setting. In this paper, the usefulness of mouse model for research of heterogeneity in response of cancer treatment was investigated.C57BL/6J and C3H/HeMs mice were used for pathological and transcriotional experiments. The thorax of mice was locally irradiated at a dose of 10 or 20 Gy. Four-fold more CD44 positive cells had accumulated in the lungs of C3H/HeMs than of C57BL/6J mice. At sites of lung inflammation, HA accumulated at 12 hours after irradiation and the rapid resolution was achieved within 2 weeks in the lungs in both C57BL/6J mice and C3H/HheMs mice. An immunochemical investigation of C57BL/6J mice lungs revealed dense collagen accumulation at 8 weeks. The expression of Cap1, II18 and Rad51ap1 was constantly higher for 72 hours in C3H/HeMs mice than C57BL/6J mice. The expression of Mmp12 and Per3 was more induced in C3H/HeMs mice than C57BL/6J mice at 12 hours after irradiation. The expresion of Ltf was especially higher at 1 hour after iiradiation and that of Ifi202a was more induced at 72 hour in C57BL/6J mice than C3H/HeMs mice. Investigations into the mechanism of radiation-induced lung damage using animal models showed a powerful impact upon molecular studies of individual radiosensitivity.Mouse Models of Human Cancer (B7

Strain dependent differences in a quantitative histological study and expression analysis in irradiated murine lung

Although clinical observation can often reveal individual differences in the severity of lung fibrosis after radiation therapy, the actual influences of inherent individual factor is difficult to determine a clinical setting. In this paper, the usefulness of mouse model for research of heterogeneity in response of cancer treatment was investigated.C57BL/6J and C3H/HeMs mice were used for pathological and transcriotional experiments. The thorax of mice was locally irradiated at a dose of 10 or 20 Gy. Four-fold more CD44 positive cells had accumulated in the lungs of C3H/HeMs than of C57BL/6J mice. At sites of lung inflammation, HA accumulated at 12 hours after irradiation and the rapid resolution was achieved within 2 weeks in the lungs in both C57BL/6J mice and C3H/HheMs mice. An immunochemical investigation of C57BL/6J mice lungs revealed dense collagen accumulation at 8 weeks. The expression of Cap1, II18 and Rad51ap1 was constantly higher for 72 hours in C3H/HeMs mice than C57BL/6J mice. The expression of Mmp12 and Per3 was more induced in C3H/HeMs mice than C57BL/6J mice at 12 hours after irradiation. The expresion of Ltf was especially higher at 1 hour after iiradiation and that of Ifi202a was more induced at 72 hour in C57BL/6J mice than C3H/HeMs mice. Investigations into the mechanism of radiation-induced lung damage using animal models showed a powerful impact upon molecular studies of individual radiosensitivity.Mouse Models of Human Cancer (B7

Inhibition of Lassa and Marburg Virus Production by Tetherin▿

Recently, tetherin has been identified as an effective cellular factor that prevents the release of human immunodeficiency virus type 1. Here, we show that the production of virus-like particles induced by viral matrix proteins of Lassa virus or Marburg virus was markedly inhibited by tetherin and that N-linked glycosylation of tetherin was dispensable for this antiviral activity. Our data also suggest that viral matrix proteins or one or more components that originate from host cells are targets of tetherin but that viral surface glycoproteins are not. These results suggest that tetherin inhibits the release of a wide variety of enveloped viruses from host cells by a common mechanism

Strain dependent differences in a histological study of CD44 and collagen fibers with an expression analysis of inflammatory response related genes in irradiated murine lung

Using a mouse model, we investigated the mechanisms of heterogeneity in response to ionizing radiation in this research. C57BL/6J and C3H/HeMs mice were irradiated with gamma rays at 10 and 20 Gy. The animals were sacrificed at times corresponding to the latent period, the pneumonic phase, and the start of the fibrotic phase for histological investigation. Small areas of fibrosis initially appeared in C57BL/6J mice at 4 weeks postirradiation with 20 Gy, whereas small inflammatory lesions appeared at 4 and 8 weeks after 20 and 10 Gy, respectively. The alveoli septa were thickened by an infiltration of inflammatory cells, and alveoli were obliterated in lungs from C57BL/6J mice after 20 Gy irradiation. At 24 hours and from 2 to 4 weeks postirradiation, fourfold more CD44 positive cells had accumulated in the lungs of C3H/HeMs than in C57BL/6J mice. Hyaluronan accumulated 12 hours after irradiation, and the rapid resolution was achieved within 2 weeks in the lungs in both strains of mice. C57BL/6J mice lungs accumulated dense collagen at 8 weeks. Quantitative RT-PCR assay was performed for several genes selected by cDNA microarray analysis. The expression of several genes, such as Cap1, Il18, Mmp12, Per3, Ltf, Ifi202a, and Rad51ap1 showed strain-dependent variances. In conclusion, a histological investigation suggested that C3H/HeMs mice were able to induce a more rapid clearance of matrix after irradiation than C57BL/6J mice. The expression analysis showed that the several genes are potentially involved in interstrain differences in inflammatory response causing radiation-induced lung fibrosis