Adapting group schema therapy for older adults with personality disorders:Lessons learnt

A first empirical study into group schema therapy in older adults with mood disorders and personality disorder (PD) features has shown that brief group schema therapy has potential to decrease psychological distress and to change early maladaptive schemas (EMS). Effect sizes however were smaller than those found in similar studies in younger adults. Therefore, we set out to adapt the treatment protocol for older adults in order to enhance its feasibility and outcome in this age group. We examined this adapted protocol in 29 older adults (mean age 66 years) with PDs from four Dutch mental health institutes. The primary outcome was symptomatic distress, measured by the Brief Symptom Inventory. Secondary outcomes were measured by the Young Schema Questionnaire, the Schema Mode Inventory, and the short version of the Severity Indices of Personality Problems. Contrary to our expectations, the adapted treatment protocol yielded only a small effect size in our primary outcome, and no significant improvement in EMS, modes and personality functioning. Patients pointed out that they were more aware of their dysfunctional patterns, but maybe they had not been able yet to work on behavioural change due to this schema therapy treatment being too brief. We recommend more intensive treatment for older patients with PDs, as they might benefit from more schema therapy sessions, similar to the treatment dosage in younger PD patients. They might also benefit from a combination of group therapy and individual treatment sessions

The spliceosome as target for anticancer treatment

The spliceosome is a ribonucleoprotein complex involved in RNA splicing, that is, the removal of non-coding introns from precursor messenger RNA. (Alternative) Splicing events may play an essential role in tumourigenesis. The recent discovery that the spliceosome is a target for novel compounds with anticancer activity opens up new therapeutic avenues

Mediatieve therapie in de thuiszorg: Onbekend en onbenut

Psychologische interventies zijn nog weinig verkend in de thuiszorg voor ouderen met probleemgedrag. In deze gevalsbeschrijving uit een mannelijke patiënt zich krenkend jegens zorgverleners, die dit gedrag willen laten ophouden. Na observatie zijn via teamleden concrete interventies ingezet, welke vooraf werden ingeoefend met rollenspel. Niethelpende gedachten die bij het oefenen opkwamen, werden uitgedaagd en vervangen door helpende varianten. Psychosociale interventies kunnen in de thuiszorg voor ouderen vruchtbaar zijn, als de onderliggende principes zijn afgestemd op de afhankelijkheid en kwetsbaarheid van de doelgroep. Enkele relevante vertrekpunten hierin worden beschreven

DESORPTION BEHAVIOUR OF POLYCYCLIC AROMATIC HYDROCARBONS IN HARBOUR SLUDGE FROM THE PORT OF ROTTERDAM, THE NETHERLANDS

Abstract. Desorption of eight polycyclic aromatic hydrocarbons (PAH) from two harbour sludges from the Port of Rotterdam, the Netherlands, was studied by column elution experiments. When water moves in a sludge layer desorbing contaminants like PAH can be dispersed in the environment. Separation of liquid and solid phase in batches of sludge, stored for more than three years, by ultra-centrifugation at 4 • C yielded equilibrium partition coefficients. Temperature effects could not account for the observed differences with reported literature values. The differences are attributed to the contact time of PAH in the sediment. Laboratory data reported in the literature were often obtained after short contact times and therefore may not represent equilibrium partitioning. Our values represent contact times in excess of three years and are therefore more representative for the field conditions. Partition coefficients obtained from column elution experiments were slightly above those obtained from the batch experiments. During column elution of the sludge from the Beneden Merwede sorption equilibrium was absent for the lighter compounds. This is attributed to the presence of a large portion of immobile water in the columns. Elution in the Beerkanaal columns occurred at near sorption equilibrium although pore water velocities were higher. Assuming that desorption is diffusion controlled, observed desorption in both materials could be explained. The non-equilibrium desorption in the Beneden Merwede sludge for phenanthrene, and to a lesser extent for anthracene and fluoranthene, could be described by a diffusion limited model assuming spherical particles

Using item response theory to explore the psychometric properties of extended matching questions examination in undergraduate medical education

BACKGROUND: As assessment has been shown to direct learning, it is critical that the examinations developed to test clinical competence in medical undergraduates are valid and reliable. The use of extended matching questions (EMQ) has been advocated to overcome some of the criticisms of using multiple-choice questions to test factual and applied knowledge. METHODS: We analysed the results from the Extended Matching Questions Examination taken by 4th year undergraduate medical students in the academic year 2001 to 2002. Rasch analysis was used to examine whether the set of questions used in the examination mapped on to a unidimensional scale, the degree of difficulty of questions within and between the various medical and surgical specialties and the pattern of responses within individual questions to assess the impact of the distractor options. RESULTS: Analysis of a subset of items and of the full examination demonstrated internal construct validity and the absence of bias on the majority of questions. Three main patterns of response selection were identified. CONCLUSION: Modern psychometric methods based upon the work of Rasch provide a useful approach to the calibration and analysis of EMQ undergraduate medical assessments. The approach allows for a formal test of the unidimensionality of the questions and thus the validity of the summed score. Given the metric calibration which follows fit to the model, it also allows for the establishment of items banks to facilitate continuity and equity in exam standards

Physical activity for people living with dementia: carer outcomes and side effects from the perspectives of professionals and family carers

Adherence to physical activity is challenging for people living with dementia, and largely dependent on carers' involvement. Carers are likely to support physical activity based on their perceived balance between benefits and potential side effects of such intervention for both patients and themselves. Professionals also have a role in terms of optimising such interventions not only for people with dementia but also their carers.publishe

Giving A Face to Chemotherapy-Induced Alopecia: A Feasibility Study on Drawings by Patients

Objective: Individuals with cancer experience the impact of chemotherapy on hair loss in different ways. The aim of this pilot study was to explore patients' experiences of alopecia through patients' drawings. Methods: Fifteen female patients diagnosed with cancer and treated with chemotherapy were recruited at the oncological day-care unit of a teaching hospital in the Netherlands. Participants completed a semi-structured interview about alopecia. They drew their head and hair before and during chemotherapy and completed the Brief Illness Perception Questionnaire (B-IPQ).Results: The drawings revealed predominantly physical effects, rather than emotions. Emotions were evident in the text that patients wrote under the drawings and in the B-IPQ open question about the perceived consequences of alopecia. The overall impact of alopecia that emerged from the drawings and the B-IPQ corresponded to the information retrieved from the interviews, namely disappointment, insecurity, sadness, and confrontation.Conclusions: Drawings expose cognitive and emotional responses to alopecia that may be relatively unexplored when using traditional assessment methods such as questionnaires or interviews. In future research, the drawing instructions need to be more specifically focused on feelings in order to better capture emotional reactions to hair loss.Experimentele farmacotherapi