摘要 :
Abstract Objective Nonsuicidal self‐injury (NSSI) recovery has typically been conceptualized through the lens of formal frameworks or as the cessation of NSSI. These understandings, however, have been developed largely devoid of ...
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Abstract Objective Nonsuicidal self‐injury (NSSI) recovery has typically been conceptualized through the lens of formal frameworks or as the cessation of NSSI. These understandings, however, have been developed largely devoid of views from those with lived NSSI experience, who may offer novel and critical insights. To advance the conception of NSSI recovery, the current study elicited such views. Methods Two hundred and thirty‐three emerging adults with a history of NSSI (77% female, mean age?=?18.9 years), responded to open‐ended questions regarding recovery. Results were thematically analyzed using an inductive approach. Results Responses yielded seven themes: (a) recovery is complete NSSI cessation; (b) recovery is more than cessation; (c) recovery involves lingering NSSI features; (d) recovery involves developing resilience; (e) recovery is a process; (f) evolution in understanding recovery; and (g) recovery is a subjective experience. Conclusion Recovery seems to be multifarious, nonlinear, and subjective. Conceptual and clinical implications are discussed.
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摘要 :
Abstract Objective Children's pain memories play a powerful role in shaping future pain experiences. Interventions aiming to reframe children's memories of painful medical procedures hold promise for altering pain memories and imp...
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Abstract Objective Children's pain memories play a powerful role in shaping future pain experiences. Interventions aiming to reframe children's memories of painful medical procedures hold promise for altering pain memories and improving subsequent pain experience; however, this evidence has not been synthesized. This brief clinical report includes a systematic review and meta‐analysis of existing memory‐reframing interventions for needle procedures in children and adolescents to stimulate future research. Methods Database searches identified relevant randomized and quasi‐randomized controlled trials. Data were extracted and pooled using Grading of Recommendations, Assessment, Development and Evaluation ( GRADE ) and Cochrane methodologies. Critically important outcomes included fear during a subsequent needle procedure; important outcomes included memory of fear and pain following the needle procedure and pain and distress during a subsequent needle procedure. Results Three studies including 158 children 3 to 18 years of age were identified. The quality of evidence was low to very low. There was no benefit for the critically important outcome of anticipatory fear; however, the test for overall effect trended toward significance ( P = 0.07). Memory‐reframing interventions were efficacious in altering children's memories of needle procedures to be less distressing. No benefit was found for acute fear or anticipatory, acute, or overall distress. Conclusions There are limited data suggesting that interventions that reframe children's memories of needle procedures hold promise for altering pain memories and potentially reducing anticipatory fear. High‐quality intervention development work is needed to determine how these interventions can be adapted to the developing child in order to lead to lasting reductions in pain, fear, and distress at future needle procedures.
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摘要 :
Abstract Objective Children's pain memories play a powerful role in shaping future pain experiences. Interventions aiming to reframe children's memories of painful medical procedures hold promise for altering pain memories and imp...
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Abstract Objective Children's pain memories play a powerful role in shaping future pain experiences. Interventions aiming to reframe children's memories of painful medical procedures hold promise for altering pain memories and improving subsequent pain experience; however, this evidence has not been synthesized. This brief clinical report includes a systematic review and meta‐analysis of existing memory‐reframing interventions for needle procedures in children and adolescents to stimulate future research. Methods Database searches identified relevant randomized and quasi‐randomized controlled trials. Data were extracted and pooled using Grading of Recommendations, Assessment, Development and Evaluation ( GRADE ) and Cochrane methodologies. Critically important outcomes included fear during a subsequent needle procedure; important outcomes included memory of fear and pain following the needle procedure and pain and distress during a subsequent needle procedure. Results Three studies including 158 children 3 to 18 years of age were identified. The quality of evidence was low to very low. There was no benefit for the critically important outcome of anticipatory fear; however, the test for overall effect trended toward significance ( P = 0.07). Memory‐reframing interventions were efficacious in altering children's memories of needle procedures to be less distressing. No benefit was found for acute fear or anticipatory, acute, or overall distress. Conclusions There are limited data suggesting that interventions that reframe children's memories of needle procedures hold promise for altering pain memories and potentially reducing anticipatory fear. High‐quality intervention development work is needed to determine how these interventions can be adapted to the developing child in order to lead to lasting reductions in pain, fear, and distress at future needle procedures.
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摘要 :
Abstract Brief and cost‐effective interventions focused on emotion regulation techniques can buffer against stress and foster positive functioning. Mindfulness and positive reappraisal are two techniques that can mutually enhance...
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Abstract Brief and cost‐effective interventions focused on emotion regulation techniques can buffer against stress and foster positive functioning. Mindfulness and positive reappraisal are two techniques that can mutually enhance one another to promote well‐being. However, research testing the effectiveness of interventions combining mindfulness and reappraisal is lacking. The current pilot examined the effect of a combined mindful‐reappraisal intervention on daily affect in a 5‐day diary study with 106 university students. Participants were randomized to a mindful‐reappraisal intervention ( n ?=?36), a reappraisal‐only intervention ( n ?=?34), or an active control activity ( n ?=?36). All participants described a negative event each day but only reappraised the event in the intervention conditions. Using multilevel growth modelling, results indicated that negative affect in both interventions declined over 5?days compared to the control; however, there were no differences in the growth of positive affect. Compared to reappraisal‐only, the mindful‐reappraisal group reported overall lower daily negative affect and marginally higher daily positive affect over the 5‐day intervention. These findings suggest that brief daily practice combining mindfulness and positive reappraisal can be trained as a self‐regulatory resource to promote positive affect and buffer negative affect above and beyond reappraisal practice alone.
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摘要 :
Abstract Aim Cardiovascular disease (CVD) risk is lower in pre‐menopausal females vs age matched males. After menopause risk equals or exceeds that of males. CVD protection of pre‐menopausal females is ascribed to high circulati...
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Abstract Aim Cardiovascular disease (CVD) risk is lower in pre‐menopausal females vs age matched males. After menopause risk equals or exceeds that of males. CVD protection of pre‐menopausal females is ascribed to high circulating oestrogen levels. Despite experimental evidence that oestrogen are cardioprotective, oestrogen replacement therapy trials have not shown clear benefits. One hypothesis to explain the discrepancy proposed hearts remodel during peri‐menopause. Peri‐menopasual myocardial changes have never been investigated, nor has the ability of oestrogen to regulate heart function during peri‐menopause. Methods We injected female mice with 4‐vinylcyclohexene diepoxide (VCD, 160 mg/kg/d IP) to cause gradual ovarian failure over 120d and act as a peri‐menopausal model Results Left ventricular function assessed by Langendorff perfusion found no changes in VCD‐injected mice at 60 or 120 days compared to intact mice. Cardiac myofilament activity was altered at 60 and 120 days indicating a molecular remodelling in peri‐menopause. Myocardial TGF‐β1 increased at 60 days post‐VCD treatment along with reduced Akt phosphorylation. Acute activation of oestrogen receptor‐α (ERα) or ‐β (ERβ) depressed left ventricular contractility in hearts from intact mice. ER‐regulation of myocardial and myofilament function, and myofilament phosphorylation, were disrupted in the peri‐menopausal model. Disruption occurred without alterations in total ERα or ERβ expression. Conclusions This is the first study to demonstrate remodelling of the heart in a model of peri‐menopause, along with a disruption in ER‐dependent regulation of the heart. These data indicate that oestrogen replacement therapy initiated after menopause affects a heart that is profoundly different from that found in reproductively intact animals.
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To evaluate the presence of quaternary ammonium compound (QAC) (resistance genes,
qac A/B
,
smr
,
qacG
, and
qacJ
, in clinical isolates of methicillin‐susceptible
Staphylococcus pseudintermedius
(MSSP) and methicillin‐resistant
S pseudintermedius
(MRSP) from dogs and the impact on in vitro chlorhexidine susceptibility.
Experimental in vitro study.
Seventy isolates from dogs colonized or infected with MRSP (n = 50) or MSSP (n = 20).
Agar dilution was used to determine the minimum inhibitory concentration (MIC) of chlorhexidine digluconate. Real‐time polymerase chain reaction was used to detect the presence of
QAC
resistance genes,
qacA/B
,
smr
,
qacG
,
and qacJ
genes.
One or more
qac
genes were identified in 52 of 70 (74%) isolates. Overall, there was no association between chlorhexidine MIC and the presence of one or more
qac
genes (
P
= .85) or the presence of
qacA/B
(
P
= .31),
smr
(
P
= .72) or
qacJ (P
= .93) individually. There was an association between
qacG
and MIC (
P
= .012), with a median MIC of 1.5?μg/mL for isolates possessing this gene and 1?μg/mL for those not possessing it.
Quaternary ammonium compound resistance genes were present in MRSP and MSSP isolates. With the exception of
qacG
, the presence of these genes was not associated with increased MIC. All isolates exhibited MIC 5000 to 80?000 times lower than the concentration recommended for use.
Despite the presence of QAC genes, chlorhexidine digluconate should be effective against MRSP and MSSP if used correctly.
To identify factors associated with surgical site infection (SSI) after tibial plateau leveling osteotomy (TPLO).
Retrospective case series.
Dogs (n = 541) that underwent TPLO (n = 659).
Medical records of dogs that underwent TPLO from 2011‐2018 were reviewed. Data collected included perioperative and postoperative antimicrobial administration, stifle inspection, duration of surgery and anesthesia, comorbidities, and development of SSI including timing, microbiological investigation, and implant removal. Referring veterinarians were contacted for all dogs without a recorded return visit. Risk factors for SSI were assessed by using a multivariable logistic regression model built by using a stepwise approach.
Surgical site infection was documented in 71 of 659 (11%) TPLO, with methicillin‐resistant
Staphylococcus pseudintermedius
accounting for 20 of 71 (28%) infections. Protective factors against SSI included administration of postoperative antimicrobials (odds ratio [OR] 0.263; 95% CI = 0.157, 0.442) and timing of preoperative antimicrobial administration. Preoperative antimicrobial timing was protective against SSI when it was administered more than 60?minutes before the first incision compared with administration within 30?minutes (OR 0.275; 95% CI = 0.112, 0.676) or within 60?minutes (OR 0.419; 95% CI = 0.189, 0.929) of the first incision.
Early administration of perioperative antimicrobials and postoperative antimicrobial administration were protective against SSI after TPLO.
Antimicrobials can influence the risk of SSI after TPLO. Perioperative and postoperative antimicrobial administration timing should be considered to reduce SSI.
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