Mental disorders make up close to one-third of the global burden of disease experienced during adolescence. Schools can play an important role in the promotion of positive mental health as well as an ...integral role in the pathways into mental health care for adolescents. In order for schools to effectively address the mental health problems of their students, educators must improve their mental health literacy. The current study examines the impact of an educator training programme designed to support educators in the delivery of a high school mental health curriculum within their classrooms, such as health class. Specifically, a paired-samples t test was used to examine the change in educators' knowledge and attitudes regarding mental health following their participation in this educator training. Eighty-three educators participated in the training, and survey data from 79 were included in the final analysis. Structured feedback on the training was obtained. Significant increases in both knowledge and attitudes scores were demonstrated. The training sessions were highly rated. Findings from this report demonstrate the potential value of mental health literacy training to improve the mental health knowledge and attitudes of educators. Improved educator knowledge and attitudes may be necessary in order for schools to provide effective mental health promotion and prevention programming.
•A 19-fold increased risk of FcaGHV1 detection identified in haemoplasma-infected cats.•Co-transmission of haemoplasmas and FcaGHV1 during territorial encounters is supported.•FcaGHV1 prevalence of ...11% of UK cats confirms globally endemic infection.•Further investigation into the role of FcaGHV1 in feline diseases is warranted.
Felis catus gammaherpesvirus 1 (FcaGHV1), a potential feline pathogen, has been identified in domestic cats from USA, Asia-Pacific and Central Europe. Transmission of FcaGHV1 during territorial encounters, a route not typical for gammaherpesviruses, is suggested by risk factor analyses from some regions. The aim of this study was to investigate the relationship between FcaGHV1 detection and risk factors, including haemoplasma co-infections, among UK cats to better understand transmission and global distribution of FcaGHV1.
FcaGHV1 DNA was detected in blood samples from UK cats (11.56%; 95% confidence interval CI, 7.47–16.84; n = 199). Logistic regression analyses showed that entire male cats were more likely to be FcaGHV1 positive than neutered male cats (odds ratio, 3.60; 95% CI, 1.22–10.46). Samples positive for DNA from any of three haemoplasma species had 19 times greater odds for testing positive for FcaGHV1 than haemoplasma negative cats in multivariable analyses after adjusting for age, sex and neuter status. Domestic cats in the UK can be infected with FcaGHV1, confirming that this virus is globally endemic. The identification of neuter status as a risk factor for FcaGHV1 detection provides further evidence to support transmission of this virus during territorial encounters and co-transmission with haemoplasmas is suggested.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Transpulmonary double-indicator dilution is a useful monitoring technique for measurement of intrathoracic blood volume (ITBV) and extravascular lung water (EVLW). In this study, we compared a ...simpler approach using single arterial thermodilution derived measurements of ITBV and EVLW with the double-indicator dilution technique.
Prospective observational clinical study.
Surgical intensive care units of two university hospitals.
Global end-diastolic volume (GEDV) derived from single thermodilution was used for calculation of ITBV. Structural regression analysis of the first two thermo-dye dilution measurements in a derivation population of 57 critically ill patients (38 male, 19 female, 18-79 years, 56 +/- 15 years) revealed ITBV = (1.25 x GEDV)-28.4 (ml). This equation was then applied to all first measurements in a validation population of 209 critically ill patients (139 male, 70 female, 10-88 years, mean 53 +/- 19 years), and single-thermodilution ITBV (ITBV(ST)) and EVLW (EVLW(ST)) was calculated and compared to thermo-dye dilution derived values (ITBV(TD), EVLW(TD)). For inter-individual comparison, absolute values for ITBV and EVLW were normalised as indexed by body surface area (ITBVI) and body weight (EVLWI), respectively.
Linear regression analysis yielded a correlation of ITBVI(ST) = (1.05 x ITBVI(TD))-58.0 (ml/m2), r = 0.97, P < 0.0001. Bias between ITBVI(TD) and ITBVI(ST) was 7.6 (ml/m2) with a standard deviation of 57.4 (ml/m2). Single-thermodilution EVLWI (EVLWI(ST)) was calculated using ITBVI(ST) and revealed the correlation EVLWI(ST) = (0.83 x EVLWI(TD)) + 1.6 (ml/kg), r = 0.96, P < 0.0001. Bias between EVLWI(TD) and EVLWI(ST) was -0.2 (ml/kg) with a standard deviation of 1.4 (ml/kg). In detail, EVLWI(ST) systematically overestimated EVLWI(TD) at low-normal values for EVLWI and underestimated EVLWI at higher values (above 12 ml/kg).
Determinations of ITBV and EVLW by single thermodilution agreed closely with the corresponding values from the double-indicator technique. Since transpulmonary single thermodilution is simple to apply, less invasive and cheaper, all these features make it a promising technique for the bedside. Nevertheless, further validation studies are needed in the future.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Children and youths use electronic technology such as the Internet more than any other medium through which to communicate and socialize. To understand the phenomenon of cyber abuse from children's ...and youths' perspectives, the authors examined anonymous posts made by children and youths to a free, 24-hour, national, bilingual phone and Web counseling, referral, and information service. The children and youths were between 11 and 24 years of age (average = 14 years). This analysis of anonymous posts by children and youths provides information about their involvement in online interactions and their experiences with cyber abuse. Findings revealed the regularity and importance of the Internet and communication technology for socialization; the forms, extent, and impact of cyber abuse; and children and youths' fear of disclosing cyber abuse to adults, particularly parents. Implications for parents, social workers, and other practitioners, researchers, and policymakers are discussed.
Full text
Available for:
BFBNIB, DOBA, IZUM, KILJ, NMLJ, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Recent advances in training for Intensive Care Medicine (ICM) have led to the introduction of competency based training, with a strong focus on the development of specific competencies at basic, ...intermediate and advanced stages of learning. This ensures trainees hold the appropriate skills and knowledge to undertake safe clinical practice, and thus provide good patient care. Respiratory Disease and its Management covers key topics, specific to the area of respiratory disease, that are addressed in the ICM training module. Issues range from conditions and illnesses such as asthma and pneumonia to treatments including ventilatory support and Inspired and Expired Gas Monitoring. Written by recognised experts in their subject area, and edited by Angela McLuckie, FRCA FJFICM Lead Clinician and Consultant Intensivist at Guy’s and St Thomas’ NHS Trust, London, UK, this book provides the reader with a compendium of knowledge and information. This book will be of special interest to critical care trainees, and will also appeal to nursing, pharmacy and physiotherapy staff.
Full text
Available for:
FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Stoat (Mustela erminea) and weasel (Mustela nivalis) populations in south-west England are declining whilst polecats (Mustela putorius), absent for over a century, are increasing. Little is known ...about the health status of these species nationally. This study aimed at investigating respiratory disease in specimens found dead in south-west England.
Trauma caused by road traffic, predator attack or being trapped was the predominant cause of death in 42 stoats, 31 weasels and 20 polecats; most were in good physical condition. Skrjabingylus nasicola was present in all species (weasels 37%, polecats 39%, stoats 41%) and infected animals showed no evidence of loss of body condition. Even in carcases stored frozen L1 larvae were frequently alive and highly motile. Angiostrongylus vasorum infection was diagnosed in two stoats and one weasel: in stoats infections were patent and the lung lesions were likely of clinical significance. These are believed to be the first records of A. vasorum in small mustelids. Pleuritis and pyothorax was seen in two polecats, in one case due to a migrating grass awn. Histological examination of lungs showed granulomata in stoats (38%), weasels (52%) and polecats (50%). Spherules consistent with Emmonsia spp. adiaspores were present in the granulomata of stoats (60%), weasels (36%) and polecats (29%). Adiaspore diameter in all three species was similar (means: stoats 39 μm, weasels 30 μm, polecats 36 μm); these are markedly smaller than that normally recorded for E. crescens. Although they lie within the accepted range for spores of Emmonsia parva this arid-zone species is not found in Britain, thus raising a question over the identity of the fungus. Cases showing numerous granulomata but few or no adiaspores were Ziehl-Neelsen-stain negative for acid-fast bacilli and IHC negative for Mycobacterium spp. However, in some cases PCR analyses revealed mycobacteria, including Mycobacterium kumamotonense and Mycobacterium avium Complex. One stoat had numerous unidentified small organisms present centrally within granulomata.
Stoats, weasels and polecats in south-west England share several respiratory diseases, often of high prevalence, but the pathology would appear insufficient to impact on the health status of the populations and other ultimate causes of death should be investigated when examining these species.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To assess the safety and efficacy of the nitric oxide synthase inhibitor 546C88 in patients with septic shock. The predefined primary efficacy objective was survival at day 28.
Multiple-center, ...randomized, two-stage, double-blind, placebo-controlled, safety and efficacy study.
A total of 124 intensive care units in Europe, North America, South America, South Africa, and Australasia.
A total of 797 patients with septic shock diagnosed for <24 hrs.
Patients with septic shock were allocated to receive 546C88 or placebo (5% dextrose) for up to 7 days (stage 1) or 14 days (stage 2) in addition to conventional therapy. Study drug was initiated at 0.05 mL.kg(-1).hr(-1) (2.5 mg.kg(-1).hr(-1) 546C88) and titrated up to a maximum rate of 0.4 mL.kg(-1).hr(-1) to maintain mean arterial pressure between 70 and 90 mm Hg while attempting to withdraw concurrent vasopressors.
Hemodynamic variables, organ function data, microbiological data, concomitant therapy, and adverse event data were recorded at baseline, throughout treatment, and at follow-up. The primary end point was day-28 survival. The trial was stopped early after review by the independent data safety monitoring board. Day-28 mortality was 59% (259/439) in the 546C88 group and 49% (174/358) in the placebo group (p <.001). The overall incidence of adverse events was similar in both groups, although a higher proportion of the events was considered possibly attributable to study drug in the 546C88 group. Most of the events accounting for the disparity between the groups were associated with the cardiovascular system (e.g., decreased cardiac output, pulmonary hypertension, systemic arterial hypertension, heart failure). The causes of death in the study were consistent with those expected in patients with septic shock, although there was a higher proportion of cardiovascular deaths and a lower incidence of deaths caused by multiple organ failure in the 546C88 group.
In this study, the nonselective nitric oxide synthase inhibitor 546C88 increased mortality in patients with septic shock.
The authors believe this to be the first case report of atrial fibrillation following pulse methylprednisolone therapy in an adult. The literature regarding the complications of pulse ...methylprednisolone therapy is reviewed, with particular emphasis on the incidence and pathogenesis of arrhythmias.
PDF
