ABSTRACT
To better support researchers and contribute constructively to international scientific discourse, Angewandte Chemie has launched two opinion-based article categories with the support of the German Chemical Society (GDCh) and the journal's governing bodies. Scientific Perspectives outline best practice in the chemical sciences while Viewpoint Articles address the culture of the chemical community.
ABSTRACT
BACKGROUND: Front-line managers play an important role in managing the performance of staff working in services for people with intellectual disability, but little is known about the practices they prefer to use to improve staff performance and whether these align with what research has shown to be effective. METHOD: This study comprised two phases. First, the present authors tested the validity and reliability of a short questionnaire designed to evaluate managers' preferences for performance improvement practices. Then, the present authors collected and analysed responses from 175 managers working in disability services in Queensland, Australia. RESULTS: The questionnaire demonstrated good content validity, concurrent validity and test-retest reliability. The participants believed strategies related to changing employee individual characteristics to be more effective than strategies aimed at improving environmental factors. CONCLUSIONS: This study provides important considerations regarding the professional development needs of front-line managers working in organizations that provide services to people with intellectual disability.
Subject(s)
Caregivers , Developmental Disabilities , Intellectual Disability , Mental Health Services/standards , Humans , Models, Theoretical , Quality ImprovementABSTRACT
A composite of the metal-organic framework (MOF) NH2 -MIL-125(Ti) and molecular and ionic nickel(II) species, catalyzed hydrogen evolution from water under UV light. In 95â v/v % aqueous conditions the composite produced hydrogen in quantities two orders of magnitude higher than that of the virgin framework and an order of magnitude greater than that of the molecular catalyst. In a 2â v/v % water and acetonitrile mixture, the composite demonstrated a TOF of 28â mol H2 â g(Ni)-1 â h-1 and remained active for up to 50â h, sustaining catalysis for three times longer and yielding 20-fold the amount of hydrogen. Appraisal of physical mixtures of the MOF and each of the nickel species under identical photocatalytic conditions suggest that similar surface localized light sensitization and proton reduction processes operate in the composite catalyst. Both nickel species contribute to catalytic conversion, although different activation behaviors are observed.
ABSTRACT
The risk of death from venous thromboembolism (VTE) is high in intensive care unit patients with neurological diagnoses. This is due to an increased risk of venous stasis secondary to paralysis as well as an increased prevalence of underlying pathologies that cause endothelial activation and create an increased risk of embolus formation. In many of these diseases, there is an associated risk from bleeding because of standard VTE prophylaxis. There is a paucity of prospective studies examining different VTE prophylaxis strategies in the neurologically ill. The lack of a solid evidentiary base has posed challenges for the establishment of consistent and evidence-based clinical practice standards. In response to this need for guidance, the Neurocritical Care Society set out to develop and evidence-based guideline using GRADE to safely reduce VTE and its associated complications.
Subject(s)
Critical Care/standards , Evidence-Based Medicine/standards , Neurology/standards , Practice Guidelines as Topic/standards , Societies, Medical/standards , Venous Thromboembolism/prevention & control , HumansABSTRACT
Treatment of N(2),N(6)-bis(6-acrylamidopyridin-2-yl)pyridine-2,6-dicarboxamide with benzimidazole gives the acyclic aza-Michael addition product N(2),N(6)-bis(6-(3-(1H-benzo[d]imidazol-1-yl)propanamido)pyridin-2-yl)pyridine-2,6-dicarboxamide (2). The macrocycle N(1),N(7)-pyridine-2,6-dimethyl-N(2),N(6)-bis(6-(3-(1H-benzo[d]imidazol-1-yl)propanamido)pyridin-2-yl)pyridine-2,6-dicarboxamide dibromide ([H(2)L(2)]Br(2)) is formed through the double alkylation of 2 with 2,6-bis(bromomethyl)pyridine. The imidazole analogues of 2 and [H(2)L(2)]Br(2) (1 and [H(2)L(1)]Br(2), respectively) have also been prepared. Mercuration of the two benzimidazolium groups in [H(2)L(2)]Br(2) with mercury(II) acetate in the presence of [N(CH(3))(4)](2)[HgBr(4)] proceeds to give [HgL(2)][HgBr(4)] in good yield. The ability of [HgL(2)][HgBr(4)] to readily partake in transmetallation reactions is demonstrated by the reaction that occurs with PdCl(2)(COD) to form [PdClL(2)][PF(6)]. The structures of 2, [HgL(2)][HgBr(4)] and [PdClL(2)][PF(6)] have been determined.
ABSTRACT
PRIMARY OBJECTIVE: To verify criterion validity of measures from a functional cognitive task (FCT) carried out with patients with severe traumatic brain injury (sTBI) at 2-5 years post-injury. METHODS AND PROCEDURES: Forty-six patients with sTBI took part in a long-term outcome study where the FCT and the Neurobehavioural Rating Scale-Revised (NBRS-R) were administered and the FIM™ instrument was rated. The FCT is a telephone information gathering task for evaluating functional cognitive skills. RESULTS: Ten of 16 measures of the FCT were significantly correlated with similar or related concepts from the NBRS-R. The FIM™ cognitive score and the individual items of this score were significantly correlated with 13 of the FCT measures and with the percentage of amount of information gathered. Internal consistency was good for 13 of 16 measures. Overall, patients generally had mild difficulty on the FCT concepts. CONCLUSION: The FCT can be used with patients with sTBI to evaluate certain aspects of functional cognition. It has good criterion validity and internal consistency, but additional research is required to further measure reliability and its applicability to other severity of TBI and to other phases of recovery.
Subject(s)
Activities of Daily Living , Brain Injuries/psychology , Cognition Disorders/psychology , Occupational Therapy/methods , Telephone , Adolescent , Adult , Aged , Aged, 80 and over , Brain Injuries/physiopathology , Cognition , Cognition Disorders/diagnosis , Disability Evaluation , Emotions , Female , Follow-Up Studies , Humans , Male , Middle Aged , Reproducibility of Results , Task Performance and Analysis , Treatment Outcome , Young AdultABSTRACT
The nature of current combat situations that U.S. military forces encounter and the use of unconventional weaponry have dramatically increased service personnel's risks of sustaining a traumatic brain injury (TBI). Although the true incidence and prevalence of combat-related TBI are unknown, service personnel returning from deployment have reported rates of concussion between 10% and 20%. The Department of Defense has recently released statistics on TBI dating back to before the wars in Iraq and Afghanistan to better elucidate the impact and burden of TBI on America's warriors and veterans. Patients with severe TBI move through a well-established trauma system of care, beginning with triage of initial injury by first-responders in the war zone to acute care to rehabilitation and then returning home and to the community. Mild and moderate TBIs may pose different clinical challenges, especially when initially undetected or if treatment is delayed because more serious injuries are present. To ensure identification and prompt treatment of mild and moderate TBI, the U.S. Congress has mandated that military and Department of Veterans Affairs hospitals screen all service personnel returning from combat. Military health professionals must evaluate them for concussion and then treat the physical, emotional, and cognitive problems that may surface. A new approach to health management and care coordination is needed that will allow medical transitions between networks of care to become more centralized and allow for optimal recovery at all severity levels. This article summarizes the care systems available for the acute management of TBI from point of injury to stateside military treatment facilities. We describe TBI assessment, treatment, and overall coordination of care, including innovative clinical initiatives now used.
Subject(s)
Brain Injuries/diagnosis , Brain Injuries/rehabilitation , Continuity of Patient Care , Military Personnel , Post-Concussion Syndrome/rehabilitation , Severity of Illness Index , Air Ambulances , Blast Injuries/complications , Brain Injuries/psychology , Critical Care , Humans , Post-Concussion Syndrome/psychology , WarfareABSTRACT
OBJECTIVE: To obtain a comprehensive understanding of long-term outcome after severe traumatic brain injury (sTBI). PARTICIPANTS: Forty-six patients with sTBI. DESIGN: Comparison of interdisciplinary evaluation results at discharge from acute care and at 2 to 5 year follow-up. MAIN MEASURES: Extended Glasgow Outcome Scale, the FIM instrument, and the Neurobehavioral Rating Scale-Revised. RESULTS: Significant improvement was observed on the FIM instrument, the Extended Glasgow Outcome Scale, and on 3 factors of the Neurobehavioral Rating Scale-Revised. These measures at discharge were significant predictors of outcome. CONCLUSION: Patients with sTBI 2 to 5 years postinjury showed relatively good physical and functional outcome but poorer cognitive and emotional outcome.
Subject(s)
Brain Injuries/rehabilitation , Brain Injuries/complications , Cognition Disorders/etiology , Female , Follow-Up Studies , Health Status Indicators , Humans , Linear Models , Male , Prognosis , Prospective Studies , Treatment OutcomeABSTRACT
The Adult Literacy Program at Hawaii State Hospital utilized techniques drawn from the Morningside Model of Generative Instruction. In a study involving psychiatric inpatients, participants were taught reading, mathematics, or both over a 6- to 8-month time span. Using the Woodcock-Johnson Psychoeducational Battery-Revised, it was determined that nearly half of the participants demonstrated academic gains during the study period. Further, a behavioral observation system indicated that participants were on-task 80% of the observation time and staff engaged in positive interactions nearly 20% of the observation time. This study is the first of its kind to document any efficacy for academic instruction with a psychiatric inpatient population.
Subject(s)
Educational Status , Hospitals, Psychiatric , Hospitals, State , Inpatients/education , Mathematics , Program Evaluation/methods , Reading , Adult , Aged , Female , Hawaii , Humans , Inpatients/psychology , Male , Mental Disorders/rehabilitation , Middle Aged , Pilot Projects , Treatment OutcomeABSTRACT
BACKGROUND & AIMS: Studies of antidepressants and psychological treatments in functional bowel disorders (FBD) are methodologically limited. The aim of this study was to assess the clinical efficacy and safety of cognitive-behavioral therapy (CBT) against education (EDU) and desipramine (DES) against placebo (PLA) in female patients with moderate to severe FBD (irritable bowel syndrome, functional abdominal pain, painful constipation, and unspecified FBD). We also evaluated the amenability of clinically meaningful subgroups to these treatments. METHODS: This randomized, comparator-controlled, multicenter trial enrolled 431 adults from the University of North Carolina and the University of Toronto with moderate to severe symptoms of FBD. Participants received psychological (CBT vs. EDU) or antidepressant (DES vs. PLA) treatment for 12 weeks. Clinical, physiologic, and psychosocial assessments were performed before and at the end of treatment. RESULTS: The intention-to-treat analysis showed CBT as significantly more effective than EDU (P = 0.0001; responder rate, 70% CBT vs. 37% EDU; number needed to treat [NNT ], 3.1). DES did not show significant benefit over PLA in the intention-to-treat analysis (P = 0.16; responder rate, 60% DES vs. 47% PLA; NNT, 8.1) but did show a statistically significant benefit in the per-protocol analysis (P = 0.01; responder rate, 73% DES vs. 49% PLA; NNT, 5.2), especially when participants with nondetectable blood levels of DES were excluded (P = 0.002). Improvement was best gauged by satisfaction with treatment. Subgroup analyses showed that DES was beneficial over PLA for moderate more than severe symptoms, abuse history, no depression, and diarrhea-predominant symptoms; CBT was beneficial over EDU for all subgroups except for depression. CONCLUSIONS: For female patients with moderate to severe FBD, CBT is effective and DES may be effective when taken adequately. Certain clinical subgroups are more or less amenable to these treatments.