ABSTRACT
Deficits in social cognition and metacognition impact the course of psychosis. Sex differences in social cognition and metacognition could explain heterogeneity in psychosis. 174 (58 females) patients with first-episode psychosis completed a clinical, neuropsychological, social cognitive, and metacognitive assessment. Subsequent latent profile analysis split by sex yielded two clusters common to both sexes (a Homogeneous group, 53% and 79.3%, and an Indecisive group, 18.3% and 8.6% of males and females, respectively), a specific male profile characterized by presenting jumping to conclusions (28.7%) and a specific female profile characterized by cognitive biases (12.1%). Males and females in the homogeneous profile seem to have a more benign course of illness. Males with jumping to conclusions had more clinical symptoms and more neuropsychological deficits. Females with cognitive biases were younger and had lower self-esteem. These results suggest that males and females may benefit from specific targeted treatment and highlights the need to consider sex when planning interventions.
Subject(s)
Cognition Disorders , Metacognition , Psychotic Disorders , Cognition , Cognition Disorders/psychology , Female , Humans , Male , Psychotic Disorders/therapy , Social CognitionABSTRACT
BACKGROUND: Since 1997, several tools based on the experiences of users and survivors of psychiatry have been developed with the goal of promoting self-determination in recovery, empowerment and well-being. OBJECTIVES: The aims of this study were to identify these tools and their distinctive features, and to know how they were created, implemented and evaluated. METHOD: This work was conducted in accordance with a published Scoping Review protocol, following the Arksey and O'Malley approach and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Five search strategies were used, including contact with user and survivor networks, academic database searching (Cochrane, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PsycARTICLES, SCOPUS, PubMed and Web of Science), grey literature searching, Google Scholar searching and reference harvesting. We focused on tools, elaborated by users and survivors, and studies reporting the main applications of them. The searches were performed between 21 July and 22 September 2022. Two approaches were used to display the data: descriptive analysis and thematic analysis. RESULTS: Six tools and 35 studies were identified, most of them originating in the USA and UK. Thematic analysis identified six goals of the tools: improving wellness, navigating crisis, promoting recovery, promoting empowerment, facilitating mutual support and coping with oppression. Of the 35 studies identified, 34 corresponded to applications of the Wellness Recovery Action Plan (WRAP). All of them, but one, evaluated group workshops implementations. The most common objective was to evaluate symptom improvement. Only eight studies included users and survivors as part of the research team. CONCLUSIONS: Only the WRAP has been widely disseminated and investigated. Despite the tools were designed to be implemented by peers, it seems they have been usually implemented without them as trainers. Even when these tools are not aimed to promote clinical recovery, in practice the most disseminated recovery tool is being used in this way.
Subject(s)
Mental Disorders , Mental Health Services , Psychiatry , Humans , Motivation , Research DesignABSTRACT
Schizophrenia is a chronic mental illness associated with several functional impairments. The International Classification of Functioning, Disability and Health (ICF) Core Sets for schizophrenia are shortlists of ICF categories that are relevant for describing the functioning and disability of people suffering from schizophrenia. The aims of this study were to explore the content validity of these Core Sets from the perspective of psychiatrists and to identify - from this perspective and using the ICF framework - the most common problems of patients with schizophrenia. In a three-round survey using the Delphi technique, psychiatrists experienced in schizophrenia treatment were asked about the problems they commonly encounter in these patients. A total of 352 psychiatrists from 63 countries representing all six WHO regions responded to the first-round questionnaire, and 303 completed all three rounds (86% response rate). From the first-round responses, 7133 concepts were extracted and linked to 387 ICF categories and 35 personal factors. Of these, consensus (≥75% agreement) was reached for 91 ICF categories and 31 personal factors. Eighty-seven of the 97 ICF categories that form the Comprehensive ICF Core Set for schizophrenia were represented in this list. Only four of the categories for which consensus was reached do not feature in the Comprehensive Core Set. From the perspective of psychiatrists the content validity of the ICF Core Sets for schizophrenia was largely supported. This suggests that these Core Sets offer an effective framework for describing functioning and disability in individuals with schizophrenia.
Subject(s)
Delphi Technique , International Classification of Functioning, Disability and Health , Psychiatry/methods , Schizophrenia/classification , Schizophrenia/diagnosis , Disability Evaluation , Female , Humans , International Cooperation , MaleABSTRACT
BACKGROUND: The consequences of breastfeeding during pregnancy (BDP) have not been clearly established. Available studies have addressed isolated aspects of this issue using different methodologies, often resulting in contradictory results. To our knowledge, no systematic review has assessed and compared these studies, making it difficult to obtain a clear picture of the consequences of BDP. AIM: To review and summarise all the scientific evidence relating to BDP, and determine whether this evidence is sufficient to establish clear implications for the mother, breastmilk, breastfed child, current pregnancy, and ultimately, the newborn. METHODS: We conducted a systematic review of the English and Spanish literature published between 1990 and 2015 using Cinahl, PubMed, IME, CUIDEN, Cochrane Library, Web of Science and PyscINFO. FINDINGS: 3278 publications were identified from databases, their titles and abstracts were checked to ensure the studies were related to the subject and met the selection criteria. Only 19 studies met all requirements and were included in the review. CONCLUSIONS AND IMPLICATIONS: Data suggest that BDP does not affect the way pregnancies end or even birth weights. However, several questions remain unanswered. Specifically, it is unclear how BDP affects maternal nutritional status in developed countries, the growth and health of breastfed siblings, the composition of breastmilk, or the growth of the newborn after delivery. Further studies of BDP are needed with larger samples, adequate methodology and proper control of the main confounders.
Subject(s)
Breast Feeding , Mothers/psychology , Pregnancy , Breast Feeding/adverse effects , Breast Feeding/ethnology , Breast Feeding/psychology , Female , Humans , Infant, Newborn , Milk, HumanABSTRACT
La osteoporosis y, secundariamente, la fractura de cadera son dos entidades inseparables que acontecen en la mayoría de los casos en individuos de edad avanzada, principalmente mujeres, y con otros problemas de salud. La elevada prevalencia de síndromes geriátricos en los pacientes con fractura de cadera requiere un abordaje integral, e integrado, entre los diferentes profesionales y niveles asistenciales que priorice la continuidad asistencial y los resultados en salud a largo plazo. Las herramientas clave en este abordaje son la valoración geriátrica integral, el trabajo en equipo interdisciplinar, la atención centrada en el paciente y las guías de práctica clínica. Los modelos de atención integrada emergen como una respuesta más adecuada en la atención a la fractura de cadera porque los diferentes agentes implicados comparten objetivos comunes, colocan al paciente en el centro de la atención, eliminan barreras y permiten racionalizar los recursos(AU)
Osteoporosis and hip fracture are two inseparable conditions in most cases in older female patients with other health problems. A comprehensive-multidisciplinary integrated approach is required because of high prevalence of geriatric syndromes in hip fracture patients. Care continuum and long-term results must be enhanced. Comprehensive geriatric assessment, multidisciplinary teamwork, patientfocused care, and evidenced-based practices are the management key tools for these patients. Integrated care models seems to be the best answer in hip fracture because common targets are shared between all implicated agents, patient is sited in the center of care, barriers are suppressed, and resources rationalized(AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Osteoporosis/complications , Osteoporosis/diagnosis , Hip Fractures/complications , Hip Fractures/diagnosis , Delivery of Health Care, Integrated/methods , Delivery of Health Care, Integrated/trends , Primary Prevention/methods , Osteoporosis/physiopathology , Osteoporosis/therapy , Hip Fractures/prevention & control , Hip Fractures/therapy , Delivery of Health Care, Integrated/organization & administration , Delivery of Health Care, Integrated/statistics & numerical data , Delivery of Health Care, Integrated , Primary Prevention/trends , Exercise/physiologyABSTRACT
BACKGROUND AND OBJECTIVE: Methicillin-resistant Staphylococcus aureus (MRSA) asymptomatic colonization is common in long-term care facilities, but the burden of symptomatic infection appears to be low. It is not usually known whether a patient is colonized at the time of admission to the geriatric facility. Our purpose was to determine the prevalence, characteristics and factors associated with MRSA colonization on admission, and the cumulative incidence of colonization over the following 6 months. PATIENTS AND METHOD: Longitudinal and prospective study conducted over a 6-month period. All patients were screened at admission using nasal and ulcers swabs within the first 24h. Patients were screened also at the end of the study to assess carrier status. RESULTS: The prevalence of MRSA colonization was 7.6% at the entry (25 patients). In the multivariate analysis, advanced age, recent use of antibiotics, prior colonization by MRSA, and peripheral vascular disease were independent risk factors for colonization at admission. With standard precautions, the 6-month cumulative incidence of MRSA colonization was 4.2%. CONCLUSIONS: In our long-term care facility, MRSA colonization at the time of admission was frequent. Few patients were colonized during the study and no episodes of infection were reported. Probably, standard precautions, including hand washing and appropriate barrier procedures during the care of wounds, are the most useful control measures.
Subject(s)
Carrier State , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Skilled Nursing Facilities , Adult , Aged , Aged, 80 and over , Female , Humans , Longitudinal Studies , Male , Middle Aged , Prospective StudiesABSTRACT
Fundamento y objetivo: la colonización por Staphylococcus aureus resistente a meticilina (SARM) es frecuente en centros de media y larga estancia, pero las tasas de infección son bajas. Habitualmente se desconoce el estado de portador de un paciente en el momento del ingreso. Nos hemos propuesto estudiar la prevalencia, las características clínicas y los factores relacionados con el hecho de ser portador al ingresar en el hospital, así como la incidencia de colonización de los pacientes una vez ingresados durante un período de 6 meses. Pacientes y método: se ha realizado un estudio longitudinal y prospectivo durante un período de 6 meses. Se efectuó a todos los pacientes un frotis nasal y de las heridas dentro de las primeras 24h de ingreso, estudio que se repitió en el momento del alta o de finalización del estudio. Resultados: la proporción de pacientes colonizados al ingresar fue del 7,6% (n=25). En el análisis multivariable, la edad, el uso reciente de antibióticos, la colonización previa y la presencia de enfermedad vascular periférica fueron las variables asociadas de forma independiente con el estado de portador. Tomando las precauciones estándar sólo un 4,2% de los pacientes se colonizaron durante el ingreso. Conclusiones: en nuestro centro de media y larga estancia, un número importante de pacientes presentó colonización por SARM al ingresar. Fueron pocos los que se colonizaron durante el ingreso y no se describieron episodios de infección durante el período del estudio. Probablemente las precauciones estándar, entre ellas el lavado de las manos y los métodos de barrera en las curas de heridas, son medidas adecuadas para evitar la diseminación de la colonización por SARM (AU)
Background and objective: Methicillin-resistant Staphylococcus aureus (MRSA) asymptomatic colonization is common in long-term care facilities, but the burden of symptomatic infection appears to be low. It is not usually known whether a patient is colonized at the time of admission to the geriatric facility. Our purpose was to determine the prevalence, characteristics and factors associated with MRSA colonization on admission, and the cumulative incidence of colonization over the following 6 months. Patients and method: Longitudinal and prospective study conducted over a 6-month period. All patients were screened at admission using nasal and ulcers swabs within the first 24h. Patients were screened also at the end of the study to assess carrier status. Results: The prevalence of MRSA colonization was 7.6% at the entry (25 patients). In the multivariate analysis, advanced age, recent use of antibiotics, prior colonization by MRSA, and peripheral vascular disease were independent risk factors for colonization at admission. With standard precautions, the 6-month cumulative incidence of MRSA colonization was 4.2%. Conclusions: In our long-term care facility, MRSA colonization at the time of admission was frequent. Few patients were colonized during the study and no episodes of infection were reported. Probably, standard precautions, including hand washing and appropriate barrier procedures during the care of wounds, are the most useful control measures (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Staphylococcus aureus/isolation & purification , Staphylococcus aureus , Methicillin Resistance , Prospective Studies , Longitudinal Studies , Hospital Bed Capacity, 100 to 299 , SpainABSTRACT
La Valoración Geriátrica Integral es la herramienta básica y fundamentalen la priorización de problemas e intervención en la atención alanciano frágil. Independientemente de cuál sea el nivel asistencial,permite realizar un análisis exhaustivo de las capacidades físicas,funcionales, del estado nutricional, de los órganos de los sentidos, delestado de ánimo y del entorno sociofamiliar que envuelve a cadapaciente. De la misma manera, tiene en cuenta las necesidades, lavoluntad y los deseos del paciente. Por este motivo, sólo a través deella, podemos coordinarnos entre los diferentes profesionales de lasalud y niveles asistenciales para priorizar el abordaje de los problemasde salud y ofrecer una asistencia integral de calidad
Integral Geriatric Assessment is the basic and fundamental tool in theprioritization of problems and supervision in the care of the frail elderly.Independent of whatever the level of care is, it permits the realization ofan exhaustive analysis of the physical and functional capabilities, thenutritional state, the sense organs, the state of mind and the social andfamily environment that surrounds each patient. In the same way, theneeds, the will and the wishes of the patient are taken into account.Therefore, only through it can we coordinate between the differenthealth professionals and levels of care to prioritise the broaching of thehealth problems and offer quality integral care
Subject(s)
Male , Female , Aged , Humans , Geriatric Assessment/methods , Day Care, Medical/methods , Delivery of Health Care, Integrated/methods , Frail Elderly/statistics & numerical data , Nutritional Status , AffectABSTRACT
In meta-analyses the extraction and coding of information from primary research reports has to be completed in a competent way because these tasks implicate most of the decisions that determine the usefulness of the final product. The authors offer guidelines that make it more likely that high-quality information is reliably extracted and coded from primary research reports. These guidelines address issues ranging from the selection of items and construction of coding materials to sustaining reliability and vigilance across extended periods of coding. Thereafter, the authors note how the methodology of meta-analysis results in pressure to change the type of information that appears in primary research reports, and close by offering a few conjectures about the future of meta-analysis.
Subject(s)
Meta-Analysis as Topic , Research Design/standards , Data Interpretation, Statistical , HumansABSTRACT
The Philadelphia Geriatric Center Morale Scale, Life Satisfaction Index, and Affect Balance Scale were translated into Castilian Spanish and Catalan. Responses to these scales were obtained by interviews with 151 elderly persons living in Spain. Reliability estimates for the Life Satisfaction Index and the Affect Balance subscales were comparable to those for English-speaking samples, while reliability estimates for the Philadelphia Geriatric Center Morale Scale were somewhat lower. Validity estimates among these scales were consistent with previous research and previously reported factor structures were found to fit the present data reasonably well, although factor loadings were lower than those previously reported. English and translated versions of the scales are provided in Appendix A.
Subject(s)
Activities of Daily Living/psychology , Attitude to Health , Cross-Cultural Comparison , Personal Satisfaction , Aged , Aged, 80 and over , Female , Humans , Male , Morale , Personality Assessment/statistics & numerical data , Psychometrics , Reproducibility of Results , Social Environment , SpainABSTRACT
The correlation between scores on the Columbia Mental Maturity Scale and on the McCarthy scales was calculated for 68 kindergarten children from three nursery schools in a lower-class urban area. Analysis indicated significant correlations for the Columbia Mental Maturity Scale with Perceptual-Performance, Quantitative, Motor Scales and General Cognitive Index and negligible values (.14 to .15) between Columbia scale and McCarthy Verbal and Memory subscales. The implications are discussed.
