ABSTRACT
AIM: The current study aimed to explore the effects of organized befriending for an Early Intervention in Psychosis (EIP) population. METHODS: Participants were randomly assigned to control or intervention groups. Those in the befriending arm were paired based on a shared interests questionnaire. Qualitative and quantitative methods were planned to assess experience and impact of the intervention across clinical and recovery outcomes. We aimed to recruit 60 participants, however only 16 participants completed the trial. RESULTS: The study was unsuccessful due to issues with recruitment and retention of participants. We gathered feedback from those who withdrew, to understand this better. CONCLUSIONS: We offer our observations to other clinicians who may be considering similar research. A more assertive researcher-led approach over the first few meetings between matched pairs is likely to have been more effective in retaining participants' engagement in the study.
Subject(s)
Psychotic Disorders , Randomized Controlled Trials as Topic , Humans , Psychotic Disorders/therapyABSTRACT
OBJECTIVE: In the last decade, repetitive transcranial magnetic stimulation (rTMS) has been introduced as a non-invasive neuromodulation therapy for depression. Little is known, however, about (serious) adverse events (AE) of rTMS in older adults with a depression. In this article, we want to study what is known about (serious) AE of rTMS in older adults (>60 years) with late-life depression (LLD). METHODS: A systematic search has been performed according to the PRISMA guidelines in PubMed, EMBase and PsycInfo. We have screened 622 articles for eligibility. Eleven studies, evaluating 353 patients in total, were included in this review. RESULTS: AE were reported in 12.4% of the older adults with a LLD treated with rTMS, serious AE in 1.5%. Headache (6.9%) and discomfort at the stimulation site (2.7%) are the most commonly reported AE. Serious AE reported are: psychiatric hospitalization (three times), a combination of posterior vitreous detachment and retinal tear, and increased suicide ideation (both once). CONCLUSIONS: rTMS in older adults with LLD was concluded overall to be safe due to the low frequency of AE reported in trials and observational studies. In case-reports, however, more serious AE have been described. To tailor use of rTMS in older adults with LLD, more research is needed in larger samples to optimize tolerance.
Subject(s)
Depression , Transcranial Magnetic Stimulation , Aged , Humans , Treatment OutcomeABSTRACT
Chronic fatigue is highly prevalent in the general population as well as in multiple chronic diseases and psychiatric disorders. Its etiology however remains poorly understood and cannot be explained by biological factors alone. Occurring in a psychosocial context, the experience and communication of fatigue may be shaped by social interactions. In particular, interpersonal operant conditioning may strengthen and perpetuate fatigue complaints. In this experiment, individuals (Nâ¯=â¯44) repeatedly rated their currently experienced fatigue while engaging in cognitive effort (working memory task). Subtle social reward was given when fatigue increased relative to the previous rating; or disapproval when fatigue decreased. In the control condition, only neutral feedback was given. Although all participants became more fatigued during cognitive effort, interpersonal operant conditioning led to increased fatigue reporting relative to neutral feedback. This effect occurred independently of conscious awareness. Interestingly, the experimental condition also performed worse on the working memory task. Results suggest that fatigue complaints (and cognitive performance) may become controlled by their consequences such as social reward, and not exclusively by their antecedents such as effort. Results have implications for treatment development and suggest that interpersonal operant conditioning may contribute to fatigue becoming a chronic symptom.
Subject(s)
Conditioning, Operant/physiology , Fatigue/psychology , Interpersonal Relations , Adolescent , Adult , Female , Humans , Male , Memory, Short-Term/physiology , Neuropsychological Tests , Young AdultABSTRACT
Our patient sought treatment for the nodules on his nose, but the nodules on his tattoos proved particularly helpful in making the diagnosis.
Subject(s)
Nose , Sarcoidosis/diagnosis , Tattooing , Adrenal Cortex Hormones/therapeutic use , Adult , Biopsy , Diagnosis, Differential , Humans , Male , Sarcoidosis/drug therapyABSTRACT
The acute and chronic consequences of ultraviolet radiation on human skin are reviewed. An awareness of variations in naturally occurring photoprotective agents and the use of glass, sunglasses, and fabric can lead to effective protection from the deleterious effects of ultraviolet radiation. New systemic agents, including Polypodium leucotomos, afamelanotide, and antioxidants have potential as photoprotective agents.
Subject(s)
Radiation Protection/methods , Ultraviolet Rays/adverse effects , HumansABSTRACT
In addition to the naturally occurring, physical, and systemic photoprotective agents reviewed in part I, topical ultraviolet radiation filters are an important cornerstone of photoprotection. Sunscreen development, efficacy, testing, and controversies are reviewed in part II of this continuing medical education article.
