From march 2020 to march 2021 : psychotherapists about working in the COVID-19 pandemic : collective autoethnography

Motywacją do napisania artykułu była potrzeba zreflektowania doświadczeń z pracy zespołu psychoterapeutów w wyjątkowym czasie od marca 2020 do marca 2021. Psychoterapeuci, którzy, wcześniej tego nie planując, opuścili swoje gabinety i usiedli przed ekranami, przeszli szybki kurs IT i uczestniczyli wspólnie z pacjentami w wielkim eksperymencie: psychoterapia w pandemii COVID-19. W zebraniu i opracowaniu materiału badawczego autorzy posłużyli się metodą zespołowej autoetnografii (collective autoethnography). Jest to metoda badań jakościowych właściwa do eksploracji nowych zjawisk społecznych, wywołujących silne emocje i mających wpływ zarówno na jednostki, jak i na grupy. Badania pokazały, że zarówno adaptacja do pracy wpandemii, jak i powrót do gabinetów ma charakter procesualny, indywidualnie (dla pacjentów i psychoterapeutów) zróżnicowany w tempie i rytmie. Pojawienie się transgresji, czyli twórczego przekształcenia myślenia, działania i otoczenia, wymaga sprzyjającego kontekstu, w którym kluczowe jest oparcie w zespole. W psychoterapii zdalnej zbieramy inny rodzaj informacji o rodzinach i pacjentach indywidualnych, wymagający dopasowania sposobów opracowania i rozumienia, settingu i kontraktu. Wprowadzenie psychoterapii on-line w większym zakresie, niż to było przed pandemią, pozwoli skorzystać z tej formy leczenia osobom, dla których była niedostępna lub dla których dostęp do niej był utrudniony. Otwarcie się psychoterapeutów na konsultacje w zespole czy w szerszym środowisku, na pracę interdyscyplinarną jest wspierającym czynnikiem w procesach adaptacji i transgresji. Praca zdalna wiąże się z przeciążeniem fizycznym i psychicznym psychoterapeutów, stąd szczególnie ważne jest dodatkowe zadbanie o superwizję i własny komfort.The incentive to write the article was to record the work experiences of a psychotherapists' team in an exceptional time from March 2020 to March 2021. Psychotherapists who, without planning it beforehand, left their offices and sat in front of the screens, took a quick IT course and participated, together with their patients, in a great experiment: Psychotherapy in the Covid-19 pandemic. The authors used the Collective Autoethnography method to collect and develop the research material. It is a qualitative research method, appropriate for the exploration of new social phenomena that evoke strong emotions and affect both individuals and groups. The research has shown that both, adaptation to work in the pandemic and return to offices are processual in nature, varying in pace and rhythm individually (for patients and psychotherapists). The emergence of transgression, i.e., a creative transformation of thinking, acting and environment, requires a favorable context, in which the key is the team support. In on-line psychotherapy, we collect different types of information about families and individual patients, requiring adjustment of developing and understanding of setting and contract. Introducing on-line psychotherapy to a greater extent than it was before the pandemic will allow us to use this way of treatment for those people, who found it unavailable or difficult to access. Opening up to consultations in a team, a wider environment and interdisciplinary work of psychotherapists is a supporting factor in the processes of adaptation and transgression. Remote work involves physical and mental overload of psychotherapists, hence additional attention needs to be paid to supervision and personal comfort

Budżetowanie działalności jednostek gospodarczych Teoria i praktyka. Część V

Z wprowadzenia: "Przekazujemy do rąk Czytelników część monografii dotyczącej budżetowania jednostek gospodarczych. Jej przygotowanie zbiegło się z ukazaniem się manifestu Precz z budżetami Jeremiego Норе’а i Robina Frasera. Autorzy poddają tam ostrej krytyce dotychczasowe praktyki stosowania budżetowania kosztowego. Stąd niniejsza publikacja - między innymi - dlatego różni się istotnie od poprzednich. Od pewnego czasu - także w Polsce - pojawiały się głosy wskazujące na istotne niedoskonałości budżetowania kosztowego, na przykład J. Gierusz [Materiały konferencyjne 2001], G. H. Świderska [Rachunkowośćzarządcza i rachunek kosztów, 2002]. Nie odnosiły one jednak skutku. Nie zauważono też dotąd narastającej listy zarzutów wytaczanych przeciw finansowym jednostkom miary stosowanym w budżetowaniu kosztowym, na przykład G. K. Świderska [jak wyżej], M. Sierpińska, B. Niedbała [Controllingoperacyjny wpnedsiębiorstwie, 2003]. Bez echa pozostało postawione przez autora pytanie: „zmierzch czy rozwój budżetowania?” [„Controlling i rachunkowość zarządcza” 9/2002], gdzie jednoznacznie wskazano, że budżetowanie kosztowe obejmuje jedynie jedną sferę działalności przedsiębiorstwa i tym samym nie może stanowić wystarczającej podstawy do sterowania przedsiębiorstwem. Zwolennicy budżetowania kosztowego nawet zgadzali się ze stawianymi zarzutami, jednak nie reagowali na propozycje zmian w filozofii i metodologii budżetowania."(...

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

The CAPOS mutation in ATP1A3 alters Na/K-ATPase function and results in auditory neuropathy which has implications for management

Cerebellar ataxia, areflexia, pes cavus, optic atrophy and sensorineural hearing impairment (CAPOS) is a rare clinically distinct syndrome caused by a single dominant missense mutation, c.2452G>A, p.Glu818Lys, in ATP1A3, encoding the neuron-specific alpha subunit of the Na+/K+-ATPase α3. Allelic mutations cause the neurological diseases rapid dystonia Parkinsonism and alternating hemiplegia of childhood, disorders which do not encompass hearing or visual impairment. We present detailed clinical phenotypic information in 18 genetically confirmed patients from 11 families (10 previously unreported) from Denmark, Sweden, UK and Germany indicating a specific type of hearing impairment-auditory neuropathy (AN). All patients were clinically suspected of CAPOS and had hearing problems. In this retrospective analysis of audiological data, we show for the first time that cochlear outer hair cell activity was preserved as shown by the presence of otoacoustic emissions and cochlear microphonic potentials, but the auditory brainstem responses were grossly abnormal, likely reflecting neural dyssynchrony. Poor speech perception was observed, especially in noise, which was beyond the hearing level obtained in the pure tone audiograms in several of the patients presented here. Molecular modelling and in vitro electrophysiological studies of the specific CAPOS mutation were performed. Heterologous expression studies of α3 with the p.Glu818Lys mutation affects sodium binding to, and release from, the sodium-specific site in the pump, the third ion-binding site. Molecular dynamics simulations confirm that the structure of the C-terminal region is affected. In conclusion, we demonstrate for the first time evidence for auditory neuropathy in CAPOS syndrome, which may reflect impaired propagation of electrical impulses along the spiral ganglion neurons. This has implications for diagnosis and patient management. Auditory neuropathy is difficult to treat with conventional hearing aids, but preliminary improvement in speech perception in some patients suggests that cochlear implantation may be effective in CAPOS patients

Global Prevalence and Major Risk Factors of Diabetic Retinopathy

OBJECTIVE To examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes. RESEARCH DESIGN AND METHODS A pooled analysis using individual participant data from population-based studies around the world was performed. A systematic literature review was conducted to identify all population-based studies in general populations or individuals with diabetes who had ascertained DR from retinal photographs. Studies provided data for DR end points, including any DR, proliferative DR, diabetic macular edema, and VTDR, and also major systemic risk factors. Pooled prevalence estimates were directly age-standardized to the 2010 World Diabetes Population aged 20–79 years. RESULTS A total of 35 studies (1980–2008) provided data from 22,896 individuals with diabetes. The overall prevalence was 34.6% (95% CI 34.5–34.8) for any DR, 6.96% (6.87–7.04) for proliferative DR, 6.81% (6.74–6.89) for diabetic macular edema, and 10.2% (10.1–10.3) for VTDR. All DR prevalence end points increased with diabetes duration, hemoglobin A1c, and blood pressure levels and were higher in people with type 1 compared with type 2 diabetes. CONCLUSIONS There are approximately 93 million people with DR, 17 million with proliferative DR, 21 million with diabetic macular edema, and 28 million with VTDR worldwide. Longer diabetes duration and poorer glycemic and blood pressure control are strongly associated with DR. These data highlight the substantial worldwide public health burden of DR and the importance of modifiable risk factors in its occurrence. This study is limited by data pooled from studies at different time points, with different methodologies and population characteristics