scholarly journals Opening Up: Clients’ Inner Struggles in the Initial Phase of Therapy

2020 ◽  
Vol 11 ◽  
Author(s):  
Gøril Solberg Kleiven ◽  
Aslak Hjeltnes ◽  
Marit Råbu ◽  
Christian Moltu
Keyword(s):  
Thematic Analysis ◽  
Initial Phase ◽  
Clinical Settings ◽  
Interpersonal Process ◽  
Inner Experiences ◽  
Interpersonal Process Recall ◽  
Building Safety ◽  
Holding Back ◽  
Opening Up

ObjectiveTo explore how clients in clinical settings experience the process of opening up and sharing their inner experiences in the initial phase of therapy.MethodsTwo psychotherapy sessions of clients (N = 11) were videotaped and followed by interviews. Interpersonal process recall was used to obtain in-depth descriptions of clients’ immediate experiences in session. A follow-up interview was conducted 3 months later. The interviews were analyzed using thematic analysis.ResultsThe data revealed how and why clients distanced themselves from inner experiences in the initial phase of therapy. The overarching theme was “Holding back and struggling to open up,” which included four subthemes: (a) fearing the intensity and consequences of negative emotions; (b) experiences of being incapable and bodily stuck; (c) being insecure about one’s worthiness and right to share inner experiences with the therapist; and (d) struggling with feeling disloyal to loved ones.ConclusionThe participants held back because they feared different consequences of opening up. A range of concerns led participants to distance themselves from their inner experiences and/or to refrain from openly talking about them to the therapist. Concerns related to appropriate interpersonal conduct as client were especially important. This knowledge is highly relevant to clinicians when building safety for psychotherapeutic work.

scholarly journals Experiences of recovery from colorectal cancer surgery after hospital discharge among the oldest old: A qualitative study

2021 ◽  
pp. 205715852199445
Author(s):  
Kristina Sundt Eriksen ◽  
Sissel Iren Eikeland Husebø ◽  
Hartwig Kørner ◽  
Kirsten Lode
Keyword(s):  
Colorectal Cancer ◽  
Thematic Analysis ◽  
Oldest Old ◽  
Healthcare Services ◽  
Hospital Data ◽  
Colorectal Cancer Surgery ◽  
Discharge From Hospital ◽  
Depth Interviews ◽  
Inductive Thematic Analysis

Colorectal cancer affects a large number of people aged ≥80 years. Little is known about how they manage after discharge from hospital. The aim of this study was to explore the experiences of individuals aged ≥80 years recovering from surgery for colorectal cancer, and the challenges they may encounter after discharge from hospital. Data were collected between January and March 2016 through in-depth interviews with ten participants approximately one month after surgery. Inductive thematic analysis was employed to analyse the data. The COREQ checklist was used in reporting this study. Two themes were identified: Managing the recovery from CRC surgery, and Insufficient follow-up from the healthcare services after CRC surgery. The findings indicate that older people treated for colorectal cancer manage surprisingly well after discharge despite challenges in their recovery; however, there are seemingly areas of improvement in their follow-up healthcare.

scholarly journals A 16-year prospective cohort study to evaluate effects of long-term fluctuations in obesity indices of prediabetics on the incidence of future diabetes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shahla Safari ◽  
Maryam Abdoli ◽  
Masoud Amini ◽  
Ashraf Aminorroaya ◽  
Awat Feizi
Keyword(s):  
High Risk ◽  
Transition Probabilities ◽  
Clinical Settings ◽  
High Tendency ◽  
Mean Values ◽  
Latent Markov Model ◽  
Term Evaluation ◽  
Obesity Indices

AbstractThis study aimed to evaluate the patterns of changes in obesity indices over time in prediabetic subjects and to classify these subjects as either having a low, moderate, and high risk for developing diabetes in the future. This study was conducted among 1228 prediabetics. The patterns of changes in obesity indices based on three measurements including first, mean values during the follow-up period, and last visit from these indices were evaluated by using the latent Markov model (LMM). The mean (standard deviation) age of subjects was 44.0 (6.8) years and 73.6% of them were female. LMM identified three latent states of subjects in terms of change in all anthropometric indices: a low, moderate, and high tendency to progress diabetes with the state sizes (29%, 45%, and 26%), respectively. LMM showed that the probability of transitioning from a low to a moderate tendency to progress diabetes was higher than the other transition probabilities. Based on a long-term evaluation of patterns of changes in obesity indices, our results reemphasized the values of all five obesity indices in clinical settings for identifying high-risk prediabetic subjects for developing diabetes in future and the need for more effective obesity prevention strategies.

Linea Vestibularis: Follow-up of a Normal Genital Structure

PEDIATRICS ◽  
1993 ◽  
Vol 92 (3) ◽  
pp. 453-456
Author(s):  
NANCY D. KELLOGG ◽  
JUAN M. PARRA
Keyword(s):  
Initial Phase ◽  
Sexually Abused ◽  
Linear Structure ◽  
Healthy Female ◽  
Genital Structure ◽  
Anatomic Variants ◽  
Physical Changes ◽  
Physical Findings ◽  
Proper Interpretation

Keen observation and precise documentation have become increasingly important in the physical evaluation of a child who may have been sexually abused. The task of proper interpretation of these [See table in the PDF file] physical findings depends on the recognition of normal anatomy. Much work has been done to differentiate normal anatomic variants from physical changes resulting from injury.1-7 In a recent study, healthy female newborns were examined to establish the presence of a white midline streak in the posterior vestibule.8 In the initial phase of this study, 123 newborns were examined. A white linear structure in the mid-posterior vestibule, termed linea vestibularis (LV), was found in 10% (n = 13) of the group and a white spot in the mid-posterior vestibule, termed partial linea vestibularis (PLV), was found in 14% (n = 17) of the group.

Effectiveness of antimicrobial hospital curtains on reducing bacterial contamination—A multicenter study

2018 ◽  
Vol 40 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Shik Luk ◽  
Viola Chi Ying Chow ◽  
Kelvin Chung Ho Yu ◽  
Enoch Know Hsu ◽  
Ngai Chong Tsang ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Bacterial Contamination ◽  
Indirect Costs ◽  
Multidrug Resistant ◽  
Clinical Settings ◽  
Carbapenem Resistant ◽  
Colony Forming Units ◽  
Multidrug Resistant Organisms ◽  
Bed Days

AbstractObjectiveTo determine the efficacy of 2 types of antimicrobial privacy curtains in clinical settings and the costs involved in replacing standard curtains with antimicrobial curtains.DesignA prospective, open-labeled, multicenter study with a follow-up duration of 6 months.SettingThis study included 12 rooms of patients with multidrug-resistant organisms (MDROs) (668 patient bed days) and 10 cubicles (8,839 patient bed days) in the medical, surgical, neurosurgical, orthopedics, and rehabilitation units of 10 hospitals.MethodCulture samples were collected from curtain surfaces twice a week for 2 weeks, followed by weekly intervals.ResultsWith a median hanging time of 173 days, antimicrobial curtain B (quaternary ammonium chlorides [QAC] plus polyorganosiloxane) was highly effective in reducing the bioburden (colony-forming units/100 cm2, 1 vs 57; P < .001) compared with the standard curtain. The percentages of MDRO contamination were also significantly lower on antimicrobial curtain B than the standard curtain: methicillin-resistant Staphylococcus aureus, 0.5% vs 24% (P < .001); carbapenem-resistant Acinetobacter spp, 0.2% vs 22.1% (P < .001); multidrug-resistant Acinetobacter spp, 0% vs 13.2% (P < .001). Notably, the median time to first contamination by MDROs was 27.6 times longer for antimicrobial curtain B than for the standard curtain (138 days vs 5 days; P = .001).ConclusionsAntimicrobial curtain B (QAC plus polyorganosiloxane) but not antimicrobial curtain A (built-in silver) effectively reduced the microbial burden and MDRO contamination compared with the standard curtain, even after extended use in an active clinical setting. The antimicrobial curtain provided an opportunity to avert indirect costs related to curtain changing and laundering in addition to improving patient safety.

Rethinking Industry—University Cooperation in Europe

1993 ◽  
Vol 7 (2) ◽  
pp. 93-97 ◽  
Author(s):  
Leenamaija Otala ◽  
Matti Otala
Keyword(s):  
Higher Education ◽  
International Competition ◽  
Research Projects ◽  
Societal Values ◽  
European Industry ◽  
World Economic ◽  
University Cooperation ◽  
University Industry ◽  
Opening Up

In the March 1993 issue of Industry and Higher Education, Matti Otala identified and briefly summarized major trends in cooperation between industry, R&D centres and universities. These trends were seen in the context of the fundamental changes which industry is experiencing in its operations, structure, mores and economics – changes which are the effects of intensifying international competition, shifting societal values, new organizational ideals, and the restructuring of several world-economic blocks. This follow-up article looks specifically at the practical impacts of these changes on university–industry relationships and focuses on the increased need to ‘recycle’ employees who have lost their skills competence, and the opening up of the universities for more and larger research projects. The authors argue that the competitiveness of European industry is at stake and highlight measures which must be taken to ensure its survival.

scholarly journals PrEP Continuation, HIV and STI Testing Rates, and Delivery of Preventive Care in a Clinic-Based Cohort

2018 ◽  
Vol 30 (5) ◽  
pp. 393-405 ◽  
Author(s):  
Matthew A. Hevey ◽  
Jennifer L. Walsh ◽  
Andrew E. Petroll
Keyword(s):  
Clinical Trials ◽  
Preventive Care ◽  
Retention In Care ◽  
Clinical Settings ◽  
Hiv Incidence ◽  
Sti Testing ◽  
Hiv And Sti Testing ◽  
Study Completion ◽  
Exposure Prophylaxis

HIV pre-exposure prophylaxis (PrEP) has been demonstrated to be a safe and effective method of reducing HIV incidence. Questions remain regarding PrEP's efficacy and outcomes in real-world clinical settings. We conducted a retrospective review to assess PrEP outcomes in an academic clinic setting and focused on retention in care, reasons for discontinuation, and receipt of appropriate preventive care (immunizations, HIV testing, and STI testing). One hundred thirty-four patients were seen between 2010 and 2016 over 309 visits. One hundred sixteen patients (87%) started daily PrEP and of those, 88 (76%) attended at least one 6-month follow-up visit. Over 60% of PrEP patients completed all recommended STI screening after starting PrEP. Only 40% of patients had all appropriate immunizations at baseline; 78% had all appropriate immunizations at study completion. This study demonstrated high rates of both retention and of attaining recommended preventive care in a clinical setting outside of the rigors of clinical trials.

scholarly journals Nitazoxanide against COVID-19 in three explorative scenarios

2020 ◽  
Vol 14 (09) ◽  
pp. 982-986
Author(s):  
José Meneses Calderón ◽  
Ma. del Rocío Figueroa Flores ◽  
Leopoldo Paniagua Coria ◽  
Jesús Carlos Briones Garduño ◽  
Jazmín Meneses Figueroa ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Positive Outcome ◽  
Hospitalized Patients ◽  
Ambulatory Setting ◽  
Medical Attention ◽  
Clinical Settings ◽  
Medicine Service ◽  
Ambulatory Patients

Introduction: Nitazoxanide has shown efficacy in vitro against coronavirus infections (MERS, SARS, SARS-CoV-2). The aim of this report is to describe the results of treating COVID-19 positive patients with nitazoxanide in three clinical settings: pregnancy/puerperium, hospitalized patients in an Internal Medicine Service and in an ambulatory setting. Methodology: This was a prospective follow-up and report of COVID-19 cases in three different situations, pregnant women, hospitalized patients receiving medical attention in an Internal Medicine Service and ambulatory patients residing in Toluca City, and Mexico City. Results: The experience with a first group of 20 women, pregnant (17) or in immediate puerperium (3) was successful in 18 cases with two unfortunate deaths. The five cases treated in an Internal Medicine service showed a positive outcome with two patients weaned from mechanical ventilation. Of the remaining 16 patients treated in an ambulatory setting, all got cured. Nitazoxanide seems to be useful against SARS-CoV-2, not only in an early intervention but also in critical condition as well as in pregnancy without undesired effects for the babies. As an adjunctive therapy budesonide was used that seems to contribute to the clinical improvement. Conclusions: Nitazoxanide could be useful against COVID-19 as a safe and available regimen to be tested in a massive way immediately.

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