Demencia, estigma y arteterapia

This paper is based on a three phase research project lasting for nine years which investigated the effectiveness of art therapy groups for older people with dementia. It consisted of a pilot lasting for one year, a two-year random control group study and a qualitative analysis of the material from the project as a whole. It proposes that the culture of exclusion which applies to older people in general is much worse for those with mental health problems, and for thosewith dementia is can be catastrophic

Studies on Lampsilis Mussels of the Upper Mississippi River

The glochidial stage of the endangered freshwater mussel, Lampsilis higginsi, and several related species was studied to provide information on their early life histories. The glochidia of L. higginsi and the three species, L. radiata siliquoidea, L. ventricosa, and Ligumia recta, were compared using morphometrics and scanning electron microscopy (SEM). The glochidia of L. higginsi were morphometrically similar to those of the related species; however, they could be distinguished using SEM by the position of the hinge ligament and the dorsal ridge width. Fifteen species of fishes were tested for their suitability as hosts for the glochidia of L. higginsi. The following were found to produce at least one juvenile mussel: northern pike (Esox lucius), brook stickleback (Culea inconstans), bluegill (Lepomis macrochirus), green sunfish (L. cyanellus), largemouth bass (Micropterus salmoides), smallmouth bass (M. dolomieui), yellow perch (Perca flavescens), and walleye (Sitzostedion vitreum vitreum). A test of host quality using three members of the Family Centrarchidae ranked smallmouth bass highest with a transformation of 7.68%, followed by green sunfish (2.43%) and bluegill (0.00038%). Two propagation methods for juvenile Lampsilis mussels were tested. In vitro culture averaged 1.28 juveniles/plate, with a transformation of 1.05%. Transformation averaged 15-24 juveniles/fish on infected host fish. The pathogenesis associated with L. radiata siliquoidea on a suitable (walleye) and an unsuitable host (common carp) was compared using light and transmission electron microscopy. Encapsulation of glochidia on walleye gills was completed by 4-6 hr at 21°C. At 24-48 hr, the capsule was thin and compact. Fibrous tissue appeared in the capsule at 48 hr and increased in quantity to the end of the infection. Excystment occurred by thinning of the capsule aided by movement of the juvenile. Most of the glochidia attached to the common carp gills did not encapsulate. Partial capsular growth was evident in some, but the portions of the capsule distal to the bite consisted of necrotic cells and debris. A few complete capsules were found at 12-48 hr; however, all glochidia were sloughed by 60 hr. There was no evidence of leucocytosis; however, the number of heterophil type cells was greater in the capsular tissue of the common carp than in walleye

Demencia, estigma y arteterapia

This paper is based on a three phase research project lasting for nine years which investigated the effectiveness of art therapy groups for older people with dementia. It consisted of a pilot lasting for one year, a two-year random control group study and a qualitative analysis of the material from the project as a whole. It proposes that the culture of exclusion which applies to older people in general is much worse for those with mental health problems, and for thosewith dementia is can be catastrophic

Machine Learning in Falls Prediction; A cognition-based predictor of falls for the acute neurological in-patient population

Background Information: Falls are associated with high direct and indirect costs, and significant morbidity and mortality for patients. Pathological falls are usually a result of a compromised motor system, and/or cognition. Very little research has been conducted on predicting falls based on this premise. Aims: To demonstrate that cognitive and motor tests can be used to create a robust predictive tool for falls. Methods: Three tests of attention and executive function (Stroop, Trail Making, and Semantic Fluency), a measure of physical function (Walk-12), a series of questions (concerning recent falls, surgery and physical function) and demographic information were collected from a cohort of 323 patients at a tertiary neurological center. The principal outcome was a fall during the in-patient stay (n = 54). Data-driven, predictive modelling was employed to identify the statistical modelling strategies which are most accurate in predicting falls, and which yield the most parsimonious models of clinical relevance. Results: The Trail test was identified as the best predictor of falls. Moreover, addition of any others variables, to the results of the Trail test did not improve the prediction (Wilcoxon signed-rank p < .001). The best statistical strategy for predicting falls was the random forest (Wilcoxon signed-rank p < .001), based solely on results of the Trail test. Tuning of the model results in the following optimized values: 68% (+- 7.7) sensitivity, 90% (+- 2.3) specificity, with a positive predictive value of 60%, when the relevant data is available. Conclusion: Predictive modelling has identified a simple yet powerful machine learning prediction strategy based on a single clinical test, the Trail test. Predictive evaluation shows this strategy to be robust, suggesting predictive modelling and machine learning as the standard for future predictive tools

The Trail Making test : a study of its ability to predict falls in the acute neurological in-patient population

Objective: To determine whether tests of cognitive function and patient-reported outcome measures of motor function can be used to create a machine learning-based predictive tool for falls. Design: Prospective cohort study. Setting: Tertiary neurological and neurosurgical center. Subjects: In all, 337 in-patients receiving neurosurgical, neurological, or neurorehabilitation-based care. Main Measures: Binary (Y/N) for falling during the in-patient episode, the Trail Making Test (a measure of attention and executive function) and the Walk-12 (a patient-reported measure of physical function). Results: The principal outcome was a fall during the in-patient stay (n = 54). The Trail test was identified as the best predictor of falls. Moreover, addition of other variables, did not improve the prediction (Wilcoxon signed-rank P < 0.001). Classical linear statistical modeling methods were then compared with more recent machine learning based strategies, for example, random forests, neural networks, support vector machines. The random forest was the best modeling strategy when utilizing just the Trail Making Test data (Wilcoxon signed-rank P < 0.001) with 68% (± 7.7) sensitivity, and 90% (± 2.3) specificity. Conclusion: This study identifies a simple yet powerful machine learning (Random Forest) based predictive model for an in-patient neurological population, utilizing a single neuropsychological test of cognitive function, the Trail Making test

Corinne Burton Memorial Trust 25 Years Exhibition

Art psychotherapists and their patients reflect on 25 years of accomplishments made possible by the Corinne Burton Memorial Trust in the field of cancer care. This exhibition and accompanying publication celebrates the incalculable contribution the Corinne Burton Memorial Trust has made to the practice of art psychotherapy with people affected by cancer, marking Sir Michael Burton’s and the Trustees’ 25 years of support for art psychotherapy at Goldsmiths. The exhibition features inspirational artwork and personal stories by past and present recipients of Corinne Burton Memorial Trust studentship as well as by Corinne Burton therapists, and their patients

Etiology of pure tricuspid regurgitation based on anular circumference and leaflet area: Analysis of 45 necropsy patients with clinical and morphologic evidence of pure tricuspid regurgitation

Despite recent renewed interest in the detection of tricuspid valve regurgitation by echocardiographic and Doppler techniques, little morphologic information is available on dysfunctioning tricuspid valves. This report describes 45 necropsy patients with clinical and morphologic evidence of pure(no element of stenosis) tricuspid regurgitation and provides morphometric observations (anular circumference, leaflet area) of the tricuspid valve useful in determining the etiology of pure tricuspid regurgitation. Of 45 patients, 24 (53%) had pure tricuspid regurgitation resulting from an anatomically abnormal valve (prolap9e in 7, papillary muscle dysfunction in 6, rheumatic disease in 5, Ebstein's anomaly in 3, infective endocarditis in 2, carcinoid tumor in 1), and 21(47%) had an anatomically normal valve with systolic pulmonary artery hypertension (cor pulmonary in 12, mitral stenosis in 9). Anular circumference was dilated (> 12 cm) in patients with various causes of pulmonary hypertension, floppy valve and Ebstein's tricuspid anomaly. Leaflet area was increased in floppy valve and Ebstein's anomaly.Of the 45 patients, 24 had pulmonary systolic artery pressure measurements available for correlation with tricuspid valve morphology. Pulmonary artery pressures accurately predicted morphologically normal from abnormal valves in 16 patients (89 %). Morphologic overlap occurred in six patients with pulmonary pressures of 41 to 54 mm Hg. Of these six, the additional knowledge of normal or dilated anular circumference correctly separated valves with normal and abnormal leaflets