Psychosocial Effects of a Holistic Ayurvedic Approach to Well-being in Health and Wellness Courses.

BackgroundAs individuals are increasingly attending health and wellness courses outside of the conventional medical system, there is a need to obtain objective data on the effects of those programs on well-being.MethodsIn total, 154 men and women (mean age 54.7 years; range 25-83) participated in 3 different holistic wellness programs based on Ayurvedic Medicine principles (Seduction of Spirit, Journey into Healing, and Perfect Health) or a vacation control group. Psychosocial outcomes included spirituality (Delaney Spirituality Scale), mindful awareness (Mindful Attention Awareness Scale), psychological flexibility (Acceptance and Action Questionnaire), mood (Center for Epidemiology Studies-Depression), and anxiety (Patient-Reported Outcomes Measurement System Anxiety Scale).ResultsParticipants in the Seduction of Spirit (P < .004), Journey into Healing (P < .05), and Perfect Health (P < .004) courses showed significant increases in spirituality as compared to vacation controls. Participants in Seduction of Spirit (P < .007) also showed significant increases in mindfulness as compared to vacation controls. Participants in the Seduction of Spirit (P < .001) and Journey into Healing (P < .05) courses showed significant decreases in depressed mood as compared to those in the Perfect Health and vacation control groups. All study participants showed similar increases in psychological flexibility (P < .01) and decreases in anxiety (P < .01).ConclusionParticipation in wellness courses that incorporate a mind-body-spirit approach to health improves multiple domains of psychosocial well-being, which persists even after course participation

Adaptation to Cesarean Birth: Implementation of an International Multisite Study

The purpose of this column is to describe the implementation of an international multisite Roy adaptation model-based study of women’s perceptions of and responses to cesarean birth. The need for the study arose from the concern that women’s childbearing needs may not be met to their full satisfaction, especially if the infant is born by cesarean. Serendipity and networking played a part in the selection of four study sites in the United States (Boston, Milwaukee, Norfolk, Oklahoma City) and two in other countries (Finland, Australia). Data were collected by nursing students and staff nurses. Post-hoc consideration of the diversity of study sites revealed opportunities for examination of the influence of the contextual stimuli of culture and geographic region on the women’s adaptation to cesarean birth. Strategies used to foster integration of teaching, practice, and research are discussed

Perspektiven von wissenschaftlichen Mitarbeiterinnen und Mitarbeitern : Eine Fallstudie zu Arbeitssituation und Entwicklungsmöglichkeiten an der Zürcher Fachhochschule aus gendertheoretischer Sicht

Seit der Gründung der Fachhochschulen Ende der 1990er Jahre kommt den wissenschaftlichen Mitarbeiterinnen und Mitarbeitern, aber auch den wissenschaftlichen Assistentinnen und Assistenten eine wachsende Bedeutung im erweiterten Leistungsauftrag der schweizerischen Fachhochschulen zu. Der Aufgabenzuwachs bedingt, dass den Mittelbauangehörigen vermehrt Aufträge in Lehre, Studierendenberatung und -betreuung, in Dienstleistungs- sowie Forschungsprojekten zugewiesen werden. Gemessen an dieser hohen Relevanz ist das tatsächlich vorhandene Wissen über eine innovative Mittelbauförderung erstaunlich gering. Erste Studien haben einen Handlungsbedarf vor allem bei den Qualifizierungs- und Entwicklungsmöglichkeiten des sehr heterogenen Mittelbaus an den Fachhochschulen aufgezeigt. Weitere Auswertungen weisen zudem auf geschlechterspezifische Unterschiede bei der Laufbahnentwicklung hin. Die Chancen und Schwierigkeiten, mit denen der Mittelbau an den Fachhochschulen konfrontiert ist, sowie die gendergerechte Nachwuchsförderung sind Themen, die bislang vom Bundesprogramm "Chancengleichheit zwischen Frauen und Männern an schweizerischen Fachhochschulen" des Bundesamtes für Berufsbildung und Technologie (BBT) wenig bearbeitet wurden – und noch viel weniger von den Fachhochschulen selbst. Das vorliegende Projekt wurde im Rahmen des Programmkredits des BBT mitfinanziert und zwischen Oktober 2011 und November 2012 durchgeführt. Fallstudie an der Zürcher Fachhochschule: Das Projekt wurde unter der Leitung der Fachstelle Gender Studies und des Instituts für Nachhaltige Entwicklung der Zürcher Hochschule für Angewandte Wissenschaften (ZHAW) und zusammen mit den Gleichstellungskoordinatorinnen der Teilschulen der Zürcher Fachhochschule (ZFH) realisiert. Beteiligt waren die Pädagogische Hochschule Zürich (PH Zürich), die School of Engineering (SoE) der ZHAW, das Departement Life Sciences und Facility Management (LSFM) der ZHAW sowie die Zürcher Hochschule der Künste (ZHdK). Weil die wissenschaftlichen Mitarbeiterinnen und Mitarbeiter im ganzen Leistungsspektrum der Fachhochschulen tätig sind und innerhalb des Mittelbaus ein grosses Gewicht haben, nahmen wir in dieser Untersuchung zur ZFH diese Personalkategorie in den Fokus. Ziel und Fragestellung: Das Ziel der Untersuchung bestand darin, herauszufinden wie Frauen und Männer im Mittelbau bzw. speziell wissenschaftliche Mitarbeiterinnen und Mitarbeiter ihre Arbeitssituation wahrnehmen, welche Karrierevorstellungen und Zukunftsperspektiven sie entwickeln und wo sie mögliche Stolpersteine für ihr berufliches Weiterkommen sehen. Die geschlechterspezifischen Aspekte in diesen Wahrnehmungen der Arbeitssituation und der beruflichen Zukunftsperspektiven sowie die indviduellen Sinnkonstruktionen sollten herausgearbeitet und dabei Gemeinsamkeiten und Unterschiede für die drei Hochschulen PH Zürich, ZHAW und ZHdK aufgezeigt werden. Ebenfalls miteinbezogen wurden Fragen nach den institutionellen Rahmenbedingungen bzw. nach objektivierbaren, materiellen und prozeduralen Aspekten der Beschäftigungssituation. Vorgehen: Die Ziele des Projekts wurden mit unterschiedlichen Methoden bearbeitet: Im Rechercheteil wurde die Literatur zum Mittelbau in der Schweiz, zu den Rahmenbedingungen der Arbeitsverhältnisse im Mittelbau an der ZFH sowie zu Genderaspekten in der Wissenschaft im deutschsprachigen Raum herausgearbeitet. Im empirischen Teil fanden einerseits Gruppendiskussionen in geschlechterhomogenen Gruppen mit 32 wissenschaftlichen Mitarbeiterinnen und Mitarbeitern statt. Andererseits wurden leitfadenzentrierte Interviews mit 10 leitenden Schlüsselpersonen, die strategisch und operativ mit Fragen zum Mittelbau beschäftigt sind, geführt. Im Syntheseteil wurden die Ergebnisse der beiden empirischen Teile miteinander verglichen. Daraus wurden vom Projektteam und den Gleichstellungskoordinatorinnen Handlungsfelder und Massnahmenvorschläge für die ZFH und ihre Teilschulen abgeleitet. Aufgrund des qualitativen Vorgehens und der Anzahl sowie der selbstselektiven Beteiligung der Diskussionsteilnehmenden ist die Repräsentativität der Ergebnisse eingeschränkt. Ergebnisse: Die Ergebnisse der Fallstudie zeigen, dass aus der Perspektive der wissenschaftlichen Mitarbeiterinnen und Mitarbeiter eine Anstellung an der ZFH sehr positiv gewertet wird. Geschätzt wird insbesondere die Tätigkeit an der Schnittstelle von Theorie und Praxis und die gegenüber den Universitäten neu vorhandenen und kreativen aber gleichzeitig mit grosser Eigeninitiative verbundenen Möglichkeiten sowie die relativ hohe Flexibilität. Die Rahmenbedingungen an der Zürcher Fachhochschule sind für die wissenschaftlichen Mitarbeiterinnen und Mitarbeiter übers Ganze gesehen gut, insbesondere im Vergleich zur Industrie und anderen Praxisfeldern ausserhalb der Hochschule. Allerdings wird eine verstärkte Vernetzung sowohl mit Privatunternehmen bzw. Non-Profit-Organisationen als auch mit anderen Hochschulen und Forschungseinrichtungen als noch nicht eingelöstes Desiderat seitens der wissenschaftlichen Mitarbeiterinnen und Mitarbeiter betont. Die Fallstudie hat gezeigt, dass wissenschaftliche Mitarbeiterinnen und Mitarbeiter ihre Tätigkeit mit hoher Motivation und Leistungsbereitschaft ausüben und gerne an der Zürcher Fachhochschule arbeiten. Im Folgenden werden die Sichtweisen der wissenschaftlichen Mitarbeiterinnen und Mitarbeiter und der befragten Schlüsselpersonen in den untersuchten Organisationseinheiten der ZFH einander gegenübergestellt

Relationships among classifications of ayurvedic medicine diagnostics for imbalances and western measures of psychological states: An exploratory study.

BackgroundAccording to Ayurveda, the traditional medical system of India, doshas are a combination of characteristics based on a five-element philosophy that drive our mental and physical tendencies. When the doshas, or functional principles, are out of balance in quality or quantity, wellbeing is adversely affected and symptoms manifest.ObjectiveThis study examined relationships among imbalances in the doshas (termed Vikruti) reported via questionnaire and Western measures of psychological states.Materials and methodsStudy participants were 101 women (n = 81) and men (n = 20), mean age 53.9 years (SD = 11.7; range 32-80). Participants completed questionnaires to categorize their Vikruti type and psychological states, which included depressed mood (CESD), anxiety (PROMIS), rumination & reflection (RRQ), mindfulness (MAAS), stress (PSS), and quality of life (Ryff).ResultsMultivariate general linear modeling, controlling for age, gender and body mass index (BMI), showed that Vata imbalance was associated with more anxiety (p ≤ 0.05), more rumination (p ≤ 0.01), less mindfulness (p ≤ 0.05), and lower overall quality of life (p ≤ 0.01). Pitta imbalance was associated with poorer mood (p ≤ 0.01) and less mindfulness (p ≤ 0.05), more anxiety (p ≤ 0.05) and stress (p ≤ 0.05). Kapha imbalance was associated with more stress (p ≤ 0.05), more rumination (p ≤ 0.05) and less reflection (p ≤ 0.05).ConclusionThese findings suggest that symptoms of mind-body imbalances in Ayurveda are differentially associated with western assessments of psychological states. Ayurvedic dosha assessment may be an effective way to assess physical as well as emotional wellbeing in research and clinical settings

Salud mental en tiempos de pandemia: ¿cuál es el impacto de Covid-19?

This article is a critical and reflective construction around the current scenario of the coronavirus pandemic and the influence that this situation has on mental health. In addition, it discusses the importance of universal health systems and the focus on actions to promote mental health in this period. It is understood that it is necessary to reflect on these issues, especially in this moment so delicate and dangerous that society lives. This essay aims to encourage discussions and guide new strategies for promoting mental health. How to cite this article: Pinheiro, Guilherme Emanuel Weiss; Kocourek, Sheila. Saúde mental em tempos de pandemia: qual o impacto do Covid-19?. Revista Cuidarte. 2020;11(3):e1250. http://dx.doi.org/10.15649/cuidarte.1250    O presente artigo trata-se de uma construção crítica e reflexiva em torno do atual cenário da pandemia do coronavírus e a influência que esta situação provoca na saúde mental. Além disso, discute sobre a importância dos sistemas universais de saúde e do foco nas ações de promoção da saúde mental neste período. Entende-se q é necessário refletir sobre estas questões, ainda mais neste momento tão delicado e perigoso que a sociedade vive. Este ensaio tem por objetivo fomentar as discussões e balizar novas estratégias de promoção da saúde mental. Como citar este artigo: Pinheiro, Guilherme Emanuel Weiss; Kocourek, Sheila. Saúde mental em tempos de pandemia: qual o impacto do Covid-19?. Revista Cuidarte. 2020;11(3):e1250. http://dx.doi.org/10.15649/cuidarte.1250    Este artículo es una construcción crítica y reflexiva en torno al escenario actual de la pandemia de coronavirus y la influencia que esta situación tiene en la salud mental. Además, discute la importancia de los sistemas de salud universales y el enfoque de las acciones para promover la salud mental en este período. Se entiende que es necesario reflexionar sobre estos temas, especialmente en este momento tan delicado y peligroso que vive la sociedad. El presente ensayo tiene por objeto alentar los debates y orientar nuevas estrategias para promover la salud mental. Como citar este artículo: Pinheiro, Guilherme Emanuel Weiss; Kocourek, Sheila. Saúde mental em tempos de pandemia: qual o impacto do Covid-19?. Revista Cuidarte. 2020;11(3):e1250. http://dx.doi.org/10.15649/cuidarte.1250   &nbsp

Teste de receptores de estrógeno e progesterona em carcinoma de mama: concordância dos resultados entre laboratórios locais e de referência no Brasil

CONTEXT AND OBJECTIVE: Breast cancer accounts for approximately one quarter of all cancers in females. Estrogen and progesterone receptor testing has become an essential part of the clinical evaluation of breast carcinoma patients, and accurate results are critical in identifying patients who may benefit from hormone therapy. The present study had the aim of investigating the concordance of the results from hormone receptor tests between a reference laboratory and local (or community) laboratories in Brazil. DESIGN AND SETTING: Retrospective study at a reference pathology laboratory. METHODS: The concordance in the results from hormone receptor tests between a reference laboratory and 146 local laboratories in Brazil was compared in relation to 500 invasive breast carcinoma cases, using immunohistochemistry. RESULTS: There was concordance in 89.4% (447/500 cases) and 85.0% (425/500 cases) of the results from estrogen (&#954; = 0.744, P < 0.001) and progesterone (&#954; = 0.688, P < 0.001) receptor tests, respectively, between local and reference laboratories. This was similar to findings in other countries. The false negative rates from estrogen and progesterone receptor tests in local laboratories were 8.7% and 14.4%, respectively. The false positive rates from estrogen and progesterone receptor tests in local laboratories were 15.5% and 16.0%, respectively. CONCLUSION: Technical and result interpretation issues may explain most of the discordances in hormone receptor testing in local laboratories. Validation of estrogen and progesterone receptor tests at local laboratories, with rigorous quality control measures, is strongly recommended in order to avoid erroneous treatment of breast cancer patients.CONTEXTO E OBJETIVO: O carcinoma de mama é responsável por cerca de um quarto de todos os cânceres em mulheres. O teste de receptores de estrógeno e progesterona se tornou parte essencial da avaliação clínica de pacientes com carcinoma de mama; assim, resultados precisos são fundamentais para identificação de pacientes que podem se beneficiar da terapia hormonal. O presente estudo tem por objetivo investigar a concordância nos resultados do teste de receptores hormonais entre um laboratório referência e laboratórios locais (ou comunitários) do Brasil. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo em laboratório referência em patologia no Brasil. MÉTODOS: A concordância nos resultados dos testes de receptores hormonais entre um laboratório referência e 146 diferentes laboratórios locais brasileiros foi comparada em 500 casos de carcinoma invasivo de mama através da imunoistoquímica. RESULTADOS: Houve concordância de 89,4% (447/500 casos) e 85,0% (425/500 casos) nos resultados dos testes de receptores de estrógeno (&#954; = 0,744, P < 0,001) e progesterona (&#954; = 0,688, P < 0,001), respectivamente, entre laboratórios locais e referência, similar à descrita em outros países. A taxa de resultados falso-negativos nos testes de receptores de estrógeno e progesterona em laboratórios locais foi de 8,7% e 14,4%, respectivamente. A taxa de resultados falso-positivos nos testes de receptores de estrógeno e progesterona em laboratórios locais foi de 15,5% e 16,0%, respectivamente. CONCLUSÃO: Questões técnicas e de interpretação dos resultados podem explicar a maior parte das discordâncias nos testes de receptores hormonais em laboratórios locais. A validação dos testes de receptores de estrógeno e progesterona pelos laboratórios locais com medidas de controle de qualidade rigorosas é fortemente recomendada de modo a evitar o tratamento errôneo de pacientes com carcinoma de mama

Identification and Characterization of AES-135, a Hydroxamic Acid-Based HDAC Inhibitor That Prolongs Survival in an Orthotopic Mouse Model of Pancreatic Cancer

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive, incurable cancer with a 20% 1 year survival rate. While standard-of-care therapy can prolong life in a small fraction of cases, PDAC is inherently resistant to current treatments, and novel therapies are urgently required. Histone deacetylase (HDAC) inhibitors are effective in killing pancreatic cancer cells in in vitro PDAC studies, and although there are a few clinical studies investigating combination therapy including HDAC inhibitors, no HDAC drug or combination therapy with an HDAC drug has been approved for the treatment of PDAC. We developed an inhibitor of HDACs, AES-135, that exhibits nanomolar inhibitory activity against HDAC3, HDAC6, and HDAC11 in biochemical assays. In a three-dimensional coculture model, AES-135 kills low-passage patient-derived tumor spheroids selectively over surrounding cancer-associated fibroblasts and has excellent pharmacokinetic properties in vivo. In an orthotopic murine model of pancreatic cancer, AES-135 prolongs survival significantly, therefore representing a candidate for further preclinical testing

Prevalence and determinants of the use of self-tests by members of the public: a mixed methods study

Background Self-tests can be used by members of the public to diagnose conditions without involving a doctor, nurse or other health professional. As technologies to design and manufacture diagnostic tests have developed, a range of self-tests have become available to the public to buy over-the-counter and via the Internet. This study aims to describe how many people have used self-tests and identify factors associated with their use. Methods A postal questionnaire will elicit basic information, including sociodemographic characteristics, and whether the person has used or would use specified self-tests. Consent will be sought to recontact people who want to participate further in the study, and interviews and focus groups will be used to develop hypotheses about factors associated with self-test use. These hypotheses will be tested in a case-control study. An in-depth questionnaire will be developed incorporating the identified factors. This will be sent to: people who have used a self-test (cases); people who have not used a self-test but would use one in the future (controls); and people who have not used and would not use a self-test (controls). Logistic regression analysis will be used to establish which factors are associated with self-test use. Discussion Self-tests do have potential benefits, for example privacy and convenience, but also potential harms, for example delay seeking treatment after a true negative result when the symptoms are actually due to another condition. It is anticipated that the outcomes from this study will include recommendations about how to improve the appropriate use of self-tests and existing health services, as well as information to prepare health professionals for patients who have used self-tests

Pulmonary Hypertension and Other Potentially Fatal Pulmonary Complications in Systemic Juvenile Idiopathic Arthritis

Objective Systemic juvenile idiopathic arthritis (JIA) is characterized by fevers, rash, and arthritis, for which interleukin‐1 (IL‐1) and IL‐6 inhibitors appear to be effective treatments. Pulmonary arterial hypertension (PAH), interstitial lung disease (ILD), and alveolar proteinosis (AP) have recently been reported with increased frequency in systemic JIA patients. Our aim was to characterize and compare systemic JIA patients with these complications to a larger cohort of systemic JIA patients. Methods Systemic JIA patients who developed PAH, ILD, and/or AP were identified through an electronic Listserv and their demographic, systemic JIA, and pulmonary disease characteristics as well as their medication exposure information were collected. Patients with these features were compared to a cohort of systemic JIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry. Results The patients (n = 25) were significantly ( P < 0.05) more likely than the CARRA registry cohort (n = 389) to be female; have more systemic features; and have been exposed to an IL‐1 inhibitor, tocilizumab, corticosteroids, intravenous immunoglobulin, cyclosporine, and cyclophosphamide. Twenty patients (80%) were diagnosed with pulmonary disease after 2004. Twenty patients (80%) had macrophage activation syndrome (MAS) during their disease course and 15 patients (60%) had MAS at pulmonary diagnosis. Sixteen patients had PAH, 5 had AP, and 7 had ILD. Seventeen patients (68%) were taking or recently discontinued (<1 month) a biologic agent at pulmonary symptom onset; 12 patients (48%) were taking anti–IL‐1 therapy (primarily anakinra). Seventeen patients (68%) died at a mean of 10.2 months from the diagnosis of pulmonary complications. Conclusion PAH, AP, and ILD are underrecognized complications of systemic JIA that are frequently fatal. These complications may be the result of severe uncontrolled systemic disease activity and may be influenced by medication exposure.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97453/1/21889_ftp.pd