Accessible Summary
What is known on the subject?
Treatment and mental health care in familiar environments are beneficial for older people experiencing mental health issues. But there are not enough ...qualified and specialized nurses who can meet the complex needs of nursing home residents experiencing mental health issues.
The University Hospital of Psychiatry Zurich, Switzerland, established an outreach interprofessional mental health service to foster the care for residents experiencing mental health issues in nursing homes. Based on existing studies, little can be said about whether nurses in nursing homes find these types of services helpful.
What does this paper add to existing knowledge?
Nurses in nursing homes caring for residents experiencing mental health issues felt relieved by having inclusive support from the interprofessional mental health service. Nurses appreciated the mental health team and felt accompanied and more confident in their daily work.
Results showed that nurses wanted to be included in the care and treatment processes and to work as partners on an equal footing with the mental health team.
What are the implications for practice?
Outreach interprofessional mental health services for nursing homes should take into account nurses' views and professional experience, and value and respect their role as nurses.
Outreach interprofessional mental health services for nursing homes should offer further training in psychiatric nursing, include an accessible contact person in the team, and develop clear processes and responsibilities.
Introduction
Outreach interprofessional mental health services for nursing homes can increase the quality of care for residents experiencing mental health issues but research on how nurses in nursing homes experience such a service is lacking worldwide.
Aim
To describe how nurses experience the involvement of an outreach interprofessional mental health team in the care for older people experiencing mental health issues in nursing homes and to identify barriers to and facilitators of interprofessional collaboration.
Method
Qualitative descriptive analysis based on 13 semi‐structured interviews. Framework analysis and complex adaptive systems theory were applied.
Results
One core theme with two main categories: Nurses experienced relief from burden through inclusive support provided by the mental health team. Main categories were feeling accompanied and confident as a nurse and partnership‐based collaboration.
Discussion
Results showed for the first time that nurses felt supported by the mental health team and were encouraged to find new ways of coping with challenging situations.
Implications for Practice
To empower nurses, mental health teams should take into account nurses' perceptions in the treatment process, value and respect their role as nurses, transfer knowledge in both formal and informal settings, establish a steady and reliable contact person, and define processes and responsibilities.
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•Pharmacophore models represent the 3D-arrangement of the chemical functionalities that make a molecule active towards its target.•Pharmacophore models are constructed either the ...ligand-based or the structure-based way.•Pharmacophore models are used for virtual screening, parallel screening, target fishing, and for SAR-studies.
Biological effects of small molecules in an organism result from favorable interactions between the molecules and their target proteins. These interactions depend on chemical functionalities, bonds, and their 3D-orientations towards each other. These 3D-arrangements of chemical functionalities that make a small molecule active towards its target can be described by pharmacophore models. In these models, chemical functionalities are represented as so-called features. Commonly, they are obtained either from a set of active compounds or directly from the observed protein–ligand interactions as present in X-ray crystal structures, NMR structures, or docking poses. In this review, we explain the basics of pharmacophore modeling including dataset generation, 3D-representations and conformational analysis of small molecules, pharmacophore model construction, model validation, and its benefits to virtual screening and other applications.
Introduction The stay of a critically ill child in a pediatric intensive care unit (PICU) is a significant experience for the family. Thus far, little is known regarding the impact of this stay on ...parents and their healthy children for whom no continuous aftercare services are offered. This study aimed to capture the post-stay experience and needs of parents after this traumatic event so that they could return to family and everyday life. Methods This qualitative descriptive study was conducted in collaboration with four pediatric intensive care units in Switzerland. It included parents whose children had fully recovered after a stay and who did not require continuous medical follow-up. All children were hospitalized in the PICU for at least 48 h. Data were collected through narrative pairs (n = 6) and individual interviews (n = 8). Interviews were audio recorded, transcribed, coded inductively according to Saldaéa, and analyzed. Results The results showed three related phases that influence each other to restore normality in daily life: Trust and inclusion in the treatment process during the stay (1), processing after the stay (2), and returning to everyday life (3). Conclusion Follow-up meetings should be available to all parents whose children have been hospitalized in the PICU. In particular, it should also be available to parents whose children have fully recovered and no longer have any medical disabilities. Keywords: Experience, Pediatric intensive care unit, Critically ill child, Follow-up, Parents, Family and daily life
Medicinal plants have historically proven their value as a source of molecules with therapeutic potential, and nowadays still represent an important pool for the identification of novel drug leads. ...In the past decades, pharmaceutical industry focused mainly on libraries of synthetic compounds as drug discovery source. They are comparably easy to produce and resupply, and demonstrate good compatibility with established high throughput screening (HTS) platforms. However, at the same time there has been a declining trend in the number of new drugs reaching the market, raising renewed scientific interest in drug discovery from natural sources, despite of its known challenges. In this survey, a brief outline of historical development is provided together with a comprehensive overview of used approaches and recent developments relevant to plant-derived natural product drug discovery. Associated challenges and major strengths of natural product-based drug discovery are critically discussed. A snapshot of the advanced plant-derived natural products that are currently in actively recruiting clinical trials is also presented. Importantly, the transition of a natural compound from a “screening hit” through a “drug lead” to a “marketed drug” is associated with increasingly challenging demands for compound amount, which often cannot be met by re-isolation from the respective plant sources. In this regard, existing alternatives for resupply are also discussed, including different biotechnology approaches and total organic synthesis.
While the intrinsic complexity of natural product-based drug discovery necessitates highly integrated interdisciplinary approaches, the reviewed scientific developments, recent technological advances, and research trends clearly indicate that natural products will be among the most important sources of new drugs also in the future.
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Agonists of the nuclear receptor PPARγ are therapeutically used to combat hyperglycaemia associated with the metabolic syndrome and type 2 diabetes. In spite of being effective in normalization of ...blood glucose levels, the currently used PPARγ agonists from the thiazolidinedione type have serious side effects, making the discovery of novel ligands highly relevant.
Natural products have proven historically to be a promising pool of structures for drug discovery, and a significant research effort has recently been undertaken to explore the PPARγ-activating potential of a wide range of natural products originating from traditionally used medicinal plants or dietary sources. The majority of identified compounds are selective PPARγ modulators (SPPARMs), transactivating the expression of PPARγ-dependent reporter genes as partial agonists. Those natural PPARγ ligands have different binding modes to the receptor in comparison to the full thiazolidinedione agonists, and on some occasions activate in addition PPARα (e.g. genistein, biochanin A, sargaquinoic acid, sargahydroquinoic acid, resveratrol, amorphastilbol) or the PPARγ-dimer partner retinoid X receptor (RXR; e.g. the neolignans magnolol and honokiol). A number of in vivo studies suggest that some of the natural product activators of PPARγ (e.g. honokiol, amorfrutin 1, amorfrutin B, amorphastilbol) improve metabolic parameters in diabetic animal models, partly with reduced side effects in comparison to full thiazolidinedione agonists. The bioactivity pattern as well as the dietary use of several of the identified active compounds and plant extracts warrants future research regarding their therapeutic potential and the possibility to modulate PPARγ activation by dietary interventions or food supplements.
Due to globalization and the resulting diversity intercultural communication is increasingly coming to the fore. In addition, long-term care is mainly staffed with caregivers who have a migration ...background, which makes successful intercultural communication all the more important. Therefore, the aim of the present study was to define recommendations by interviewing relatives which can be used to promote intercultural communication in long-term care with regard to relationship building.
A qualitative explorative content analysis, which follows the content-structuring method with an inductive approach. The semi-structured guided individual interviews were conducted with relatives (n = 14) of residents from two retirement centers in Switzerland.
Four categories were defined: “Perceive communication as a need”, “Consider the desire for recognition of relatives”, “Promote readiness of caregivers”, and “Know opportunities and challenges in intercultural communication”.
Intercultural communication means being aware of the significance of culture and one's own origins in order to recognize the peculiarities of the counterpart and to interact sensitively with them. Relatives want to be actively involved when nurses reach their limits in communication and interaction. Relatives want safe care that is based on empathy. When nurses show concern towards others in a person-centered way and are aware of where they come from, this can promote trust and contribute significantly to supporting communication and interaction between cultures.
Interkulturelle Kommunikation rückt aufgrund der Globalisierung und der daraus resultierenden Vielfalt zunehmend in den Vordergrund. Hinzu kommt, dass in der Langzeitpflege überwiegend Pflegekräfte mit Migrationserfahrung tätig sind, was eine erfolgreiche interkulturelle Kommunikation umso wichtiger macht. Ziel der vorliegenden Studie war es daher, durch Befragung von Angehörigen Empfehlungen zu erarbeiten, die zur Förderung der interkulturellen Kommunikation in der Langzeitpflege im Hinblick auf die Beziehungsgestaltung eingesetzt werden können.
Eine qualitative explorative Inhaltsanalyse, die dem inhaltsstrukturierenden Ansatz mit einem induktiven Vorgehen folgte. Die halbstrukturierten leitfadengestützten Einzelinterviews wurden mit Angehörigen (n = 14) von Bewohnern aus zwei Alterszentren in der Schweiz durchgeführt.
Vier Kategorien wurden definiert: „Kommunikation als Bedürfnis wahrnehmen“, „Wunsch nach Anerkennung der Angehörigen berücksichtigen“, „Bereitschaft der Pflegenden fördern“ und „Chancen und Herausforderungen der interkulturellen Kommunikation kennen“.
Interkulturell zu kommunizieren bedeutet, sich über die Bedeutung der Kultur und der eigenen Herkunft bewusst zu werden, um die Eigenheiten des Gegenübers zu erkennen und sensibel mit ihnen umgehen zu können. Angehörige wollen aktiv einbezogen werden, wenn Pflegende in der Kommunikation und Interaktion an ihre Grenzen stoßen. Angehörige wünschen sich eine sichere Pflege, die auf Empathie beruht. Wenn Pflegende sich auf eine personenzentrierte Weise um andere kümmern und sich ihrer Herkunft bewusst sind, kann dies das Vertrauen fördern und wesentlich zur Unterstützung der Kommunikation und Interaktion zwischen den Kulturen beitragen.
Computational methods are well-established tools in the drug discovery process and can be employed for a variety of tasks. Common applications include lead identification and scaffold hopping, as ...well as lead optimization by structure-activity relationship analysis and selectivity profiling. In addition, compound-target interactions associated with potentially harmful effects can be identified and investigated. This review focuses on pharmacophore-based virtual screening campaigns specifically addressing the target class of hydroxysteroid dehydrogenases. Many members of this enzyme family are associated with specific pathological conditions, and pharmacological modulation of their activity may represent promising therapeutic strategies. On the other hand, unintended interference with their biological functions, e.g., upon inhibition by xenobiotics, can disrupt steroid hormone-mediated effects, thereby contributing to the development and progression of major diseases. Besides a general introduction to pharmacophore modeling and pharmacophore-based virtual screening, exemplary case studies from the field of short-chain dehydrogenase/reductase (SDR) research are presented. These success stories highlight the suitability of pharmacophore modeling for the various application fields and suggest its application also in futures studies.
Diseases of the central nervous system are an alarming global problem showing an increasing prevalence. Dopamine receptor D2 (D2R) has been shown to be involved in central nervous system diseases. ...While different D2R-targeting drugs have been approved by the FDA, they all suffer from major drawbacks due to promiscuous receptor activity leading to adverse effects. Increasing the number of potential D2R-targeting drug candidates bears the possibility of discovering molecules with less severe side-effect profiles. In dire need of novel D2R ligands for drug development, combined in silico/in vitro approaches have been shown to be efficient strategies. In this study, in silico pharmacophore models were generated utilizing both ligand- and structure-based approaches. Subsequently, different databases were screened for novel D2R ligands. Selected virtual hits were investigated in vitro, quantifying their binding affinity towards D2R. This workflow successfully identified six novel D2R ligands exerting micro- to nanomolar (most active compound KI = 4.1 nM) activities. Thus, the four pharmacophore models showed prospective true-positive hit rates in between 4.5% and 12%. The developed workflow and identified ligands could aid in developing novel drug candidates for D2R-associated pathologies.
Background:
The elderly represents the fastest growing group in our population. Since there is a close relationship between the number of older people and health care expenditure, promoting healthy ...aging has become an important topic. However, it is essential to understand first the needs of this population in order to create suitable programs and activities.
Methods:
A qualitative design was used in this study to explore the subjective views of elderly people and to learn more about their health-related needs. A total of 12 participants were recruited using a consecutive sampling strategy. The data were collected through semi-structured interviews and analyzed by employing a summarizing content analysis.
Results:
This study has identified 4 areas of health-related needs: Independence and autonomy, social security, structure in daily life and community and belonging, where all categories are interrelated and interact with one other.
Conclusion:
Focusing more on community-based approaches would support creating a conducive environment. Also, home visits undertaken by a specialized nurse focused on health risks and disabilities could be an adequate approach to support the elderly population in an efficient way and to offer targeted programs and activities.
Objective
The aim of this study is to identify the sources of illness-related emotional distress from the perspective of individuals living with mild to severe chronic obstructive pulmonary disease ...(COPD).
Methods
A qualitative study design with purposive sampling was applied at a Swiss University Hospital. Eleven interviews were conducted with individuals who suffered from COPD. To analyze data, framework analysis was used, guided by the recently presented model of illness-related emotional distress.
Results
Six main sources for COPD-related emotional distress were identified: physical symptoms, treatment, restricted mobility, restricted social participation, unpredictability of disease course and COPD as stigmatizing disease. Additionally, life events, multimorbidity and living situation were found to be sources of non-COPD-related distress. Negative emotions ranged from anger, sadness, and frustration to desperation giving rise to the desire to die. Although most patients experience emotional distress regardless of the severity of COPD, the sources of distress appear to have an individual manifestation.
Discussion
There is a need for a careful assessment of emotional distress among patients with COPD at all stages of the disease to provide patient-tailored interventions.
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