There has been a recent increase in research considering the perceptions of the term “cancer survivor” held by individuals who have or have had cancer. This article explores the meaning of the term ...to young women living with a history of breast cancer. Twenty women participated in semi‐structured interviews about their experience of breast cancer. The methodology was informed by social constructionist grounded theory. Three of the women interviewed said they would use the term survivor to describe themselves, but most of the women felt it did not fit with their experiences. The accounts of those who accepted and rejected the survivor identity are explored, and subthemes in the latter are “survivor as somebody else” and “cancer's ongoing presence.” This article calls into question the basing of intervention strategies on the notion of the “cancer survivor,” and the assumption that younger women favour the survivor identity. Participants struggled with the demand to live up to the ideal of the survivor, which implied a high degree of agency where in reality, cancer was a disempowering experience. Being labelled a survivor obscured ongoing impacts of cancer on the young women's lives.
Psychologists tend to report high levels of occupational stress, with serious implications for themselves, their clients, and the discipline as a whole. Recent research suggests that self-compassion ...is a promising construct for psychologists in terms of its ability to promote psychological wellbeing and resilience to stress; however, the potential benefits of self-compassion are yet to be thoroughly explored amongst this occupational group. Additionally, while a growing body of research supports self-compassion as a key predictor of psychopathology, understanding of the processes by which self-compassion exerts effects on mental health outcomes is limited. Structural equation modelling (SEM) was used to test an emotion regulation model of self-compassion and stress among psychologists, including postgraduate trainees undertaking clinical work (n = 198). Self-compassion significantly negatively predicted emotion regulation difficulties and stress symptoms. Support was also found for our preliminary explanatory model of self-compassion, which demonstrates the mediating role of emotion regulation difficulties in the self-compassion-stress relationship. The final self-compassion model accounted for 26.2% of variance in stress symptoms. Implications of the findings and limitations of the study are discussed.
The Professional Quality of Life scale is a measure intended to provide practitioners and researchers with an indication of a caring professional's compassion satisfaction, burnout, and secondary ...traumatic stress. While this measure has been used extensively in nursing research, owing to the relevancy of patient-care associated satisfaction and fatigue within this profession, information regarding the construct validity of this measure is less well represented in the literature. We examined the construct validity of the Professional Quality of Life scale using a Rasch analysis procedure on each of its three scales, as a means of substantiating their measurement adequacy. Responses on the Professional Quality of Life scale from 1615 registered nurses (age x̅ = 46.48 years, SD = 11.78) were analysed. While support for the measurement adequacy (invariance, person/item fit, and unidimensionality) of the compassion satisfaction scale was found, the burnout and secondary traumatic stress scales did not demonstrate adequate measurement properties. We instead present an alternative measurement model of these subscales, involving items from each, to form a robust measure of compassion fatigue, and provide recoding, scoring, and normed scores for both measures. Our findings indicate that use of the Professional Quality of Life scale's burnout and secondary traumatic stress scales may require caution, while our revised compassion satisfaction and fatigue scales provide robust measurement options for practitioners and researchers.
Principles of early drug discovery Hughes, JP; Rees, S; Kalindjian, SB ...
British journal of pharmacology,
March 2011, Letnik:
162, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Developing a new drug from original idea to the launch of a finished product is a complex process which can take 12–15 years and cost in excess of $1 billion. The idea for a target can come from a ...variety of sources including academic and clinical research and from the commercial sector. It may take many years to build up a body of supporting evidence before selecting a target for a costly drug discovery programme. Once a target has been chosen, the pharmaceutical industry and more recently some academic centres have streamlined a number of early processes to identify molecules which possess suitable characteristics to make acceptable drugs. This review will look at key preclinical stages of the drug discovery process, from initial target identification and validation, through assay development, high throughput screening, hit identification, lead optimization and finally the selection of a candidate molecule for clinical development.
Nurse resilience: A concept analysis Cooper, Alannah L.; Brown, Janie A.; Rees, Clare S. ...
International journal of mental health nursing,
August 2020, Letnik:
29, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Nurse resilience is attracting increasing attention in research and practice. Possession of a high level of resilience is cited as being crucial for nurses to succeed professionally and manage ...workplace stressors. There is no agreed definition of nurse resilience. A concept analysis was undertaken to examine nurse resilience using a priori selected analysis framework. This concept analysis aims to systematically analyse resilience as it relates to nurses and establish a working definition of nurse resilience. Sixty‐nine papers met the search criteria for inclusion. Key attributes of nurse resilience were social support, self‐efficacy, work–life balance/self‐care, humour, optimism, and being realistic. Resilience enables nurses to positively adapt to stressors and adversity. It is a complex and dynamic process which varies over time and context and embodies both individual attributes and external resources. Sustaining nurse resilience requires action and engagement from both individuals and organizations.
Summary
Background
There is little up‐to‐date review evidence on the prevalence of Helicobacter pylori across Europe.
Aim
To establish regional and national patterns in H. pylori prevalence across ...Europe. Secondly, to establish trends over time in H. pylori prevalence and gastric cancer incidence and, thirdly, to report on the relationship between H. pylori prevalence and age group across Europe.
Methods
A review of H. pylori prevalence from unselected surveys of adult or general populations across 35 European countries and four European regions since 1990. Secondly, an analysis of trends over time in H. pylori prevalence and in gastric cancer incidence from cancer registry data.
Results
Helicobacter pylori prevalence was lower in northern and western Europe than in eastern and southern Europe (P < 0.001). In 11 of 12 European studies that reported on trends, there were sharp reductions in H. pylori prevalence (mean annual reduction = 3.1%). The mean annual reduction in the incidence of gastric cancer across Europe from 1993 to 2007 was 2.1% with little variation regionally across Europe (north 2.2%, west 2.3%, east 1.9% and south 2.0%). Sharp increases in age‐related prevalence of H. pylori often levelled off for middle age groups of about 50 years onwards, especially in areas with high prevalence.
Conclusions
This review shows that H. pylori prevalence is much higher in less affluent regions of Europe and that age‐related increases in prevalence are confined to younger age groups in some areas. There were sharp reductions in both H. pylori prevalence and gastric cancer incidence throughout Europe.
Results are presented from a monitoring study of the performance of a sample of UK domestic PV systems. Five-minute average climatic and performance data was recorded for 27 PV systems at two sites ...for up to 2 years of operation. On average, the annual energy losses due to faults were 3.6% (Site A, first year of operation), 6.6% (Site A, second year of operation) and 18.9% (Site B, first year of operation). Simple empirical models are constructed to describe the performance of the PV systems under ‘normal operation’ (when no faults occur). New analysis techniques are developed which estimate the energy losses of four different fault categories: sustained zero efficiency faults; brief zero efficiency faults; shading; and non-zero efficiency non-shading faults. The results demonstrate that faults have the potential to cause significant energy losses in domestic PV systems. The benefits of applying the data analysis techniques described in this work to PV system clusters and other urban micro-generation technologies are discussed.
Stress cardiomyopathy, also referred to as Takotsubo cardiomyopathy, is an increasingly recognized clinical syndrome characterized by acute reversible apical ventricular dysfunction. We hypothesize ...that stress cardiomyopathy is a form of myocardial stunning, but with different cellular mechanisms to those seen during transient episodes of ischemia secondary to coronary stenoses. In this syndrome, we believe that high levels of circulating epinephrine trigger a switch in intracellular signal trafficking in ventricular cardiomyocytes, from G(s) protein to G(i) protein signaling via the beta(2)-adrenoceptor. Although this switch to beta(2)-adrenoceptor-G(i) protein signaling protects against the proapoptotic effects of intense activation of beta(1)-adrenoceptors, it is also negatively inotropic. This effect is greatest at the apical myocardium, in which the beta-adrenoceptor density is greatest. Our hypothesis has implications for the use of drugs or devices in the treatment of patients with stress cardiomyopathy.
Cognitive-behavioral therapy (CBT) has demonstrated efficacy and effectiveness for treating mood and anxiety disorders. Dissemination of CBT via videoconference may help improve access to treatment.
...The present study aimed to compare the effectiveness of CBT administered via videoconference to in-person therapy for a mixed diagnostic cohort.
A total of 26 primarily Caucasian clients (mean age 30 years, SD 11) who had a primary Diagnostic and Statistical Manual of Mental Disorders, 4th edition text revision (DSM-IV-TR) diagnosis of a mood or anxiety disorder were randomly assigned to receive 12 sessions of CBT either in-person or via videoconference. Treatment involved individualized CBT formulations specific to the presenting diagnosis; all sessions were provided by the same therapist. Participants were recruited through a university clinic. Symptoms of depression, anxiety, stress, and quality of life were assessed using questionnaires before, after, and 6 weeks following treatment. Secondary outcomes at posttreatment included working alliance and client satisfaction.
Retention was similar across treatment conditions; there was one more client in the videoconferencing condition at posttreatment and at follow-up. Statistical analysis using multilevel mixed effects linear regression indicated a significant reduction in client symptoms across time for symptoms of depression (P<.001, d=1.41), anxiety (P<.001, d=1.14), stress (P<.001, d=1.81), and quality of life (P<.001, d=1.17). There were no significant differences between treatment conditions regarding symptoms of depression (P=.165, d=0.37), anxiety (P=.41, d=0.22), stress (P=.15, d=0.38), or quality of life (P=.62, d=0.13). There were no significant differences in client rating of the working alliance (P=.53, one-tailed, d=-0.26), therapist ratings of the working alliance (P=.60, one-tailed, d=0.23), or client ratings of satisfaction (P=.77, one-tailed, d=-0.12). Fisher's Exact P was not significant regarding differences in reliable change from pre- to posttreatment or from pretreatment to follow-up for symptoms of depression (P=.41, P=.26), anxiety (P=.60, P=.99), or quality of life (P=.65, P=.99) but was significant for symptoms of stress in favor of the videoconferencing condition (P=.03, P=.035). Difference between conditions regarding clinically significant change was also not observed from pre- to posttreatment or from pretreatment to follow-up for symptoms of depression (P=.67, P=.30), anxiety (P=.99, P=.99), stress (P=.19, P=.13), or quality of life (P=.99, P=.62).
The findings of this controlled trial indicate that CBT was effective in significantly reducing symptoms of depression, anxiety, and stress and increasing quality of life in both in-person and videoconferencing conditions, with no significant differences being observed between the two.
Australian New Zealand Clinical Trials Registry ID: ACTRN12609000819224; http://www.anzctr.org.au/ACTRN12609000819224.aspx (Archived by WebCite at http://www.webcitation.org/6Kz5iBMiV).
General anaesthesia decreases pulmonary compliance and increases pulmonary shunt due to the development of atelectasis. The presence of capnoperitoneum during laparoscopic surgery may further ...decrease functional residual capacity, promoting an increased amount of atelectasis compared with laparotomy. The aim of this study was to evaluate the effects of different levels of positive end-expiratory pressure (PEEP) in both types of surgery and to investigate whether higher levels of PEEP should be used during laparoscopic surgery.
This prospective observational study included 52 patients undergoing either laparotomy or laparoscopic surgery. Three levels of PEEP were applied in random order: (1) zero (ZEEP), (2) 5 cmH2O and (3) 10 cmH2O. Pulmonary shunt and ventilation/perfusion mismatch were assessed by the automatic lung parameter estimator system.
Pulmonary shunt was similar in both groups. However, in laparotomy, a PEEP of 5 cmH2O significantly decreased shunt when compared with ZEEP (12 vs 6%; P+0.001), with additional PEEP having no further effect. In laparoscopic surgery, a significant reduction in shunt (13 vs 6%; P+0.001) was obtained only at a PEEP of 10 cmH2O. Although laparoscopic surgery was associated with a lower pulmonary compliance, increasing levels of PEEP were able to ameliorate it in both groups.
Both surgeries have similar negative effects on pulmonary shunt, while the presence of capnoperitoneum reduced only the pulmonary compliance. It appears that a more aggressive PEEP level is required to reduce shunt and to maximize compliance in case of laparoscopic surgery.
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