"WHOSE GROUPS ARE THESE ANYWAY?" ON STAFF AND PATIENTS’ NEEDS AND THEIR IMPACT ON THE MILIEU

The psychiatric ward is a complex organization. It contains two main groups: the patients and the staff. The different needs of each group influence the encounters between patients, the consumers, and staff, the suppliers. We shall discuss those needs and analyze the ways they interfere with or complement the therapeutic group work. For example: staff members need specific therapeutic group work for their professional development, and the patients need the group in order to maintain some form of interpersonal contact and to keep themselves active. The staff holds therapeutic groups in order to monitor the activity on the ward, while the patients seek a space where they can express their concerns about their treatment. Some vignettes will be presented which demonstrate these different needs, of staff and patients, and the way they were explored in the staff’s group supervision meetings

Acute inflammatory response to contrast agent aspiration and its mechanisms in the rat lung.

Objectives/hypothesisContrast agent (CA) aspiration is an established complication of upper gastrointestinal and videofluoroscopic swallow studies. The underlying molecular biological mechanisms of acute response to CA aspiration in the respiratory organs remain unclear. The aims of this study were to elucidate the histological and biological influences of three kinds of CAs on the lung and to clarify the differences in acute responses.Study designAnimal model.MethodsEight-week-old male Sprague Dawley rats were divided into five groups (n = 6 in each group). Three groups underwent tracheal instillation of one of three different CAs: barium (Ba) sulfate, nonionic contrast agents (NICAs), and ionic contrast agents (ICAs). A control group was instilled with saline and a sham group was instilled with air. All animals were euthanized on day 2 after treatment and histological and gene analysis was performed.ResultsNo animal died after CA or control/sham aspiration. Ba caused severe histopathologic changes and more prominent inflammatory cell infiltration in the lungs compared with the two other iodinated contrast agents. Increases in expressions of inflammatory cytokines (tumor necrosis factor [Tnf], interleukin-1β [Il1b], and interferon-γ [Ifng]) were observed in Ba aspiration rats, and upregulation of Il1b was seen in ICA aspiration rats. NICA did not cause obvious histologic changes or expressions of inflammatory cytokines and fibrosis-related genes in the lungs.ConclusionsBa caused significantly more acute lung inflammation in a rodent model than did ioinic and nonionic iodinated CAs. Nonionic contrast did not cause any discernible inflammatory response in the lungs, suggesting that it may be the safest contrast for videofluoroscopic swallow studies.Level of evidenceNA Laryngoscope, 129:1533-1538, 2019

Validation of the PILL-5: A 5-Item Patient Reported Outcome Measure for Pill Dysphagia.

Objectives: Pill dysphagia is common and costly with a significant risk of pill retention, caustic injury, and poor medication compliance. The purpose of this investigation was to determine the validity and reliability of the PILL-5, a self-administered patient reported outcome measure (PROM) to quantify the degree of pill (tablet and capsule) dysphagia. The PILL-5 is a 5-item questionnaire with a maximum symptom score of 20. Methods: The PILL-5 was administered to 190 patients with dysphagia referred for videofluoroscopic esophagography (VFE). Construct validity was assessed by comparing PILL-5 composite scores to delayed barium tablet transit on VFE. Normative data was obtained by administering the instrument to a cohort of healthy community based volunteers. Internal consistency was assessed with the Cronbach alpha. Test/retest reliability was determined by administering the instrument to the same cohort of patients at two time points. Results: The mean PILL-5 was 5.6 (±4.9) for persons with dysphagia and 1.6 (±2.7) for healthy volunteers (p < 0.001). The internal consistency of the instrument was high (Cronbach alpha = 0.85). The mean PILL-5 was 4.3 (±4.1) for patients with normal transit and 7.6 (±5.3) for patients with delayed barium tablet transit on esophagography, indicating excellent criterion based validity (p < 0.001). Reproducibility was high with an intraclass correlation coefficient of 0.83 (p < 0.001). Conclusions: Healthy individuals report some degree of swallowing difficulty with pills. Normative data suggest that a PILL-5 > 6 is abnormal (mean + 2 SD). The instrument demonstrated excellent criterion based validity and reliability. The PILL-5 is the first validated patient reported outcome measure for pill dysphagia

Involvement of heparanase in the pathogenesis of acute kidney injury: Nephroprotective effect of PG545

Despite the high prevalence of acute kidney injury (AKI) and its association with increased morbidity and mortality, therapeutic approaches for AKI are disappointing. This is largely attributed to poor understanding of the pathogenesis of AKI. Heparanase, an endoglycosidase that cleaves heparan sulfate, is involved in extracellular matrix turnover, inflammation, kidney dysfunction, diabetes, fibrosis, angiogenesis and cancer progression. The current study examined the involvement of heparanase in the pathogenesis of ischemic reperfusion (I/R) AKI in a mouse model and the protective effect of PG545, a potent heparanase inhibitor. I/R induced tubular damage and elevation in serum creatinine and blood urea nitrogen to a higher extent in heparanase over-expressing transgenic mice vs. wild type mice. Moreover, TGF-\u3b2, vimentin, fibronectin and \u3b1-smooth muscle actin, biomarkers of fibrosis, and TNF\u3b1, IL6 and endothelin-1, biomarkers of inflammation, were upregulated in I/R induced AKI, primarily in heparanase transgenic mice, suggesting an adverse role of heparanase in the pathogenesis of AKI. Remarkably, pretreatment of mice with PG545 abolished kidney dysfunction and the up-regulation of heparanase, pro-inflammatory (i.e., IL-6) and pro-fibrotic (i.e., TGF-\u3b2) genes induced by I/R. The present study provides new insights into the involvement of heparanase in the pathogenesis of ischemic AKI.Our results demonstrate that heparanase plays a deleterious role in the development of renal injury and kidney dysfunction,attesting heparanase inhibition as a promising therapeutic approach for AKI

Hydrogeology and Hydrochemistry of the Ogallala Aquifer, Southern High Plains

The Ogallala aquifer, which underlies the Southern High Plains, consists of the saturated sediments of the Ogallala Formation (Neogene). It serves as the main source of water for the High Plains of Texas and New Mexico but has been severely depleted due to extensive pumpage. The hydrology and hydrochemistry of the aquifer are influenced by the surface topography of the underlying formations and the thickness and permeability of formation deposits. Two distinct hydrogeologic provinces were observed. The first province, located along paleo valleys filled with coarse fluvial sediments, exhibits increased formation thickness and saturated section, as well as higher porosities and hydraulic conductivities. Ground-water flow lines within this province follow the orientation of the paleo valleys. The hydrochemical composition in this province remains relatively constant, characterized by Ca-HCO3 to mixed-HCO3 water, depleted in 0180, δD, and tritium. In contrast, the second hydrogeologic province features thinner and less permeable formations, primarily composed of fine-grained eolian elastics. Ground-water discharge from aquifers in the Cretaceous contributes to the hydrochemical facies, resulting in isotopic compositions different from those of the first province. Cross-formational movement of water and low permeability in the Ogallala Formation in these areas lead to varying hydrochemical facies and isotopic compositions. Secondary factors influencing the chemical composition of Ogallala Formation ground water include contamination from evaporating saline lakes, agricultural chemicals and fertilizers, and oil field brines. The impact of these chemicals may increase in the future as contaminants continue to move through the unsaturated zone toward the water table.Bureau of Economic Geolog

Comment on "On the subtleties of searching for dark matter with liquid xenon detectors"

In a recent manuscript (arXiv:1208.5046) Peter Sorensen claims that XENON100's upper limits on spin-independent WIMP-nucleon cross sections for WIMP masses below 10 GeV "may be understated by one order of magnitude or more". Having performed a similar, though more detailed analysis prior to the submission of our new result (arXiv:1207.5988), we do not confirm these findings. We point out the rationale for not considering the described effect in our final analysis and list several potential problems with his study.Comment: 3 pages, no figure

Characterization Study of the Ogallala Aquifer, Northwest Texas

The Ogallala aquifer, which is the main water supply in the High Plains of Texas, is being severely depleted by extensive pumpage for irrigation. The aquifer overlies the Permian evaporites that are being considered as a potential repository for the disposal of high-level nuclear wastes. Potential contamination of the aquifer by these wastes and further depletion of the limited water resources are major concerns of the people in the area. The purpose of this work is to develop a general hydrogeologic characterization of the aquifer that will serve as a firm basis for accurate evaluation of aquifer recharge mechanisms relevant to problems stemming from accidental spills of radionuclides at the land surface and possible interactions of the radionuclides with deeper hydrologic units. Aquifer hydraulics relevant to problems that may be encountered in shaft construction were studied as well. The existing geologic, hydrologic, geochemical, and isotopic data are integrated into a regional hydrogeologic model for water and solutes. The model enables (1) an understanding of recharge/discharge relationships, ages of water, and rock-water interactions, and (2) the tracing of cross-formational flow between the Ogallala and the underlying aquifers. This report presents preliminary conclusions of research conducted from August 1984 through August 1985.Bureau of Economic Geolog

The Association between Hiatal Hernia and Esophageal Dysmotility

Hiatal hernia (HH) involves the displacement of abdominal organs through the esophageal hiatus to above the diaphragm into the thoracic cavity. The overall prevalence of HH varies between 10-80% and increases with age, higher intrabdominal pressure (ex: obesity), genetic predisposition, congenital defect, and trauma. Sliding HH results in acid and non-acid reflux. Chronic exposure of the esophagus to refluxate can results in dysphagia, difficulty swallowing, due to impaired esophageal motility