Pitfalls in managing depression in older persons - electroconvulsive therapy retains a vital role?

Objective: As part of a quality improvement process, we propose a model of routinely monitoring electroconvulsive therapy (ECT) in Canadian provinces using linked health administrative databases to generate provincial periodic reports, influence policy, and standardise ECT practices. Methods: ECT practice in Quebec was studied from 1996 to 2013, using longitudinal data from the Quebec Integrated Chronic Disease Surveillance System of the Institut National de Santé Publique du Québec, which links 5 health administrative databases. The population included all persons, aged 18 y and over, eligible for the health insurance registry, who received an ECT treatment at least once during the year. Results: Among recorded cases, 75% were identified by physician claims and hospitalisation files, 19% exclusively by physician claims, and 6% by hospitalisation files. From 1996 to 2013, 8,149 persons in Quebec received ECT with an annual prevalence rate of 13 per 100,000. A decline was observed, which was more pronounced in women and in older persons. On average, each patient received 9.7 treatments of ECT annually. The proportion of acute ECT decreased whereas maintenance treatment proportions increased. A wide variation in the use of ECT was observed among regions and psychiatrists. Conclusion: This study demonstrates the profitable use of administrative data to monitor ECT use in Quebec, and provides a reliable method that could be replicated in other Canadian provinces. Although Quebec has one of the lowest utilisation rates reported in industrialized countries, regional disparities highlighted the need for a deeper examination of the quality and monitoring of ECT care and services.

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Skin Ageing: Pathophysiology and Current Market Treatment Approaches

Current Aging Science ◽

10.2174/1567205016666190809161115 ◽

2020 ◽

Vol 13 (1) ◽

pp. 22-30 ◽

Cited By ~ 2

Author(s):

Manupriya Chaudhary ◽

Azmi Khan ◽

Madhu Gupta

Keyword(s):

Cell Cycle ◽

Free Radical ◽

Older People ◽

Older Persons ◽

Biomedical Applications ◽

Vital Role ◽

Review Article ◽

Natural Phenomenon ◽

Endogenous Factors ◽

Exogenous Factors

: Ageing is a natural phenomenon which is a fold, ridge and crease in the skin that occurs due to loss of body mass, poor hydration, disintegration of dermis and epidermis junction. The Skin ageing process involves many changes that occur due to the combination of both endogenous factors (gene mutation, cellular metabolism, and hormonal factor) and exogenous factors (U.V, pollutants, chemical, and toxins). In 1950, the number of older people were found to be almost 205 million across the globe. But this number almost got 4 times by the year 2012 and the number of older persons increased to a massive amount of 810 million. The ageing of the skin occurs due to various mechanisms like glycation, free radical, cell cycle, and cellular and molecular mechanism of skin ageing. In this review article, we have discussed the treatment, worldwide newer therapies and marketed formulation that are currently available for the reduction of skin ageing. The most promising and revolutionizing field of nanotechnology is mostly applied in the field of dermatology, cosmetics, and biomedical applications. Nanotechnology also plays a vital role in increasing the efficacy of the product.

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Older Persons’ Experiences of Depressive Ill-Health and Family Support

Nursing Research and Practice ◽

10.1155/2013/837529 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

Anne Lyberg ◽

Anne Lise Holm ◽

Erna Lassenius ◽

Ingela Berggren ◽

Elisabeth Severinsson

Keyword(s):

Family Support ◽

Older Persons ◽

Family Members ◽

Vital Role ◽

Main Theme ◽

Emotional Needs ◽

Semistructured Interviews ◽

The Family ◽

Shame And Guilt ◽

Internal Relationships

The aim of this study was to explore experiences of the meaning of family support among older persons with depressive ill-health. Data were collected from twenty-nine participants through semistructured interviews and analysed using interpretative hermeneutic and reflective methodology. The findings revealed a main theme, hovering between feelings of belongingness and aloneness in relationships with family members, based on two themes: a sense of being worthy and a sense of being unworthy. Experiences of support and lack of support from family members were not opposites but connected in internal relationships and can be pictured as a movement on a continuum of ambiguity. Family support promotes the emotional needs of older persons with depressive ill-health to be confirmed. The family plays a vital role, not always by direct assistance, but indirectly by supporting the older person’s own “guiding principles” for managing her/his situation. The feelings of aloneness as well as shame and guilt at poor or absent family responsiveness should be adequately addressed. Innovative nursing care can lead to improvement by focusing on acquiescence to the older person’s life situation.

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Ultrastructure of Lymphatic Capillaries in the Transport of Colloidal Particles

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100060945 ◽

1967 ◽

Vol 25 ◽

pp. 186-187

Author(s):

L. V. Leak ◽

J. F. Burke

Keyword(s):

Connective Tissue ◽

Colloidal Particles ◽

Ultrastructural Level ◽

Vital Role ◽

Time Intervals ◽

Thorium Dioxide ◽

Lymphatic Capillary ◽

Tissue Area ◽

Rapid Removal ◽

Tissue Fluids

The vital role played by the lymphatic capillaries in the transfer of tissue fluids and particulate materials from the connective tissue area can be demonstrated by the rapid removal of injected vital dyes into the tissue areas. In order to ascertain the mechanisms involved in the transfer of substances from the connective tissue area at the ultrastructural level, we have injected colloidal particles of varying sizes which range from 80 A up to 900-mμ. These colloidal particles (colloidal ferritin 80-100A, thorium dioxide 100-200 A, biological carbon 200-300 and latex spheres 900-mμ) are injected directly into the interstitial spaces of the connective tissue with glass micro-needles mounted in a modified Chambers micromanipulator. The progress of the particles from the interstitial space into the lymphatic capillary lumen is followed by observing tissues from animals (skin of the guinea pig ear) that were injected at various time intervals ranging from 5 minutes up to 6 months.

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Three-Dimensional reconstruction of isolated centrosomes by automated electron tomography

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100169286 ◽

1994 ◽

Vol 52 ◽

pp. 310-311

Author(s):

M.B. Braunfeld ◽

M. Moritz ◽

B.M. Alberts ◽

J.W. Sedat ◽

D.A. Agard

Keyword(s):

Electron Tomography ◽

Three Dimensional ◽

Vital Role ◽

Complex Nature ◽

Animal Cells ◽

Microtubule Organizing Center ◽

Nucleation Sites ◽

Dimensional Reconstruction ◽

Organizing Center ◽

Resolution Model

In animal cells, the centrosome functions as the primary microtubule organizing center (MTOC). As such the centrosome plays a vital role in determining a cell's shape, migration, and perhaps most importantly, its division. Despite the obvious importance of this organelle little is known about centrosomal regulation, duplication, or how it nucleates microtubules. Furthermore, no high resolution model for centrosomal structure exists.We have used automated electron tomography, and reconstruction techniques in an attempt to better understand the complex nature of the centrosome. Additionally we hope to identify nucleation sites for microtubule growth.Centrosomes were isolated from early Drosophila embryos. Briefly, after large organelles and debris from homogenized embryos were pelleted, the resulting supernatant was separated on a sucrose velocity gradient. Fractions were collected and assayed for centrosome-mediated microtubule -nucleating activity by incubating with fluorescently-labeled tubulin subunits. The resulting microtubule asters were then spun onto coverslips and viewed by fluorescence microscopy.

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A Case of Catatonia in a 14-Year-Old Girl with Schizophrenia Treated with Electroconvulsive Therapy

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000211 ◽

2013 ◽

Vol 41 (1) ◽

pp. 69-74 ◽

Cited By ~ 10

Author(s):

Frank Häßler ◽

Olaf Reis ◽

Steffen Weirich ◽

Jacqueline Höppner ◽

Birgit Pohl ◽

...

Keyword(s):

Case Report ◽

Treatment Response ◽

Electroconvulsive Therapy ◽

Rating Scale ◽

Combined Treatment ◽

Adolescent Patient

This article presents a case of a 14-year-old female twin with schizophrenia who developed severe catatonia following treatment with olanzapine. Under a combined treatment with amantadine, electroconvulsive therapy (ECT), and (currently) ziprasidone alone she improved markedly. Severity and course of catatonia including treatment response were evaluated with the Bush-Francis Catatonia Rating Scale (BFCRS). This case report emphasizes the benefit of ECT in the treatment of catatonic symptoms in an adolescent patient with schizophrenic illness.

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Effects of a Group Program to Increase Cognitive Performance Through Cognitively Stimulating Leisure Activities in Healthy Older Subjects

GeroPsych ◽

10.1024/1662-9647/a000035 ◽

2011 ◽

Vol 24 (2) ◽

pp. 83-92 ◽

Cited By ~ 22

Author(s):

Valentina A. Tesky ◽

Christian Thiel ◽

Winfried Banzer ◽

Johannes Pantel

Keyword(s):

Cognitive Function ◽

Cognitive Performance ◽

Older Persons ◽

Intervention Program ◽

Leisure Activities ◽

The Elderly ◽

Cognitive Stimulation ◽

Group Program ◽

Positive Effects ◽

Older Subjects

To investigate the effects of leisure activities on cognitive performance of healthy older subjects, an innovative intervention program was developed. Frequent participation in cognitively stimulating activities (i.e., reading, playing chess, or playing music) is associated with reduced risk of dementia. AKTIVA (active cognitive stimulation – prevention in the elderly) is an intervention program designed to enhance cognitive stimulation in everyday life by increasing cognitive stimulating leisure activities. The present study determines the effects of AKTIVA on cognitive function, mood and attitude toward aging in a sample of older participants from the general population. Several measurement instruments were used including the Alzheimer’s Disease Assessment Scale (ADAS-Cog), the Trail-Making Test (TMT), and the Memory Complaint Questionnaire (MAC-Q). Initially, the sample consisted of 307 older persons (170 female, 72 ± 7 years). The intervention was evaluated with a randomized, controlled pre-post follow-up design. Participants were randomly assigned to one of three conditions: AKTIVA intervention (n = 126), AKTIVA intervention plus nutrition and exercise counseling (n = 84), no-intervention control group (n = 97). The AKTIVA intervention consisted of 8 weekly sessions and two booster sessions after a break of 4 months. Participation in the group program resulted in positive effects on cognitive function and attitude toward aging for subassembly groups. Older persons (≥ 75 years) showed enhanced speed of information processing (by TMT Version A) (F = 4.17*, p < .05); younger participants (< 75 years) showed an improvement in subjective memory decline (by MAC-Q) (F = 2.55*, p < .05). Additionally, AKTIVA enhanced the frequency of activities for leisure activities for subassembly groups. The results of this study suggest that the AKTIVA program can be used to increase cognitively stimulating leisure activities in the elderly. Further research is necessary to identify the long-term effects of this intervention particularly with respect to the prevention of dementia.

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The Case of Thematic Tests Adapted to Older Adults

Rorschachiana Journal of the International Society for the Rorschach ◽

10.1027/1192-5604/a000015 ◽

2011 ◽

Vol 32 (1) ◽

pp. 46-71 ◽

Cited By ~ 6

Author(s):

Benoît Verdon

Keyword(s):

Older Adults ◽

Older Persons ◽

Older Men ◽

Elderly Persons ◽

Mental Processes ◽

Men And Women ◽

Projective Tests ◽

New Material ◽

Older Men And Women ◽

Latent Content

Since the 1950s, the growing interest of clinicians in using projective tests to study normal or pathological aging processes has led to the creation of several thematic tests for older adults. This development reflects their authors’ belief that the TAT is not suitable to the concerns and anxieties of elderly persons. The new material thus refers explicitly to situations related to age; it aims to enable older persons to express needs they cannot verbalize during consultations. The psychodynamic approach to thematic testing is based on the differentiation between the pictures’ manifest and latent content, eliciting responses linked to mental processes and issues the respondent is unaware of. The cards do not necessarily have to show aging characters to elicit identification: The situations shown in the pictures are linked to loss, rivalry, helplessness, and renunciation, all issues elderly respondents can identify with and that lead them to express their mental fragilities and resources. The article first explains the principles underlying four of these thematic tests, then develops several examples of stories told for card 3BM of the TAT, thus showing the effectiveness of this tool for the understanding and differentiation of loss-related issues facing older men and women.

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