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  • 1
    Language: English
    In: Journal of advanced nursing, June 2011, Vol.67(6), pp.1232-41
    Description: This article is a report of a study of the key influences on family-staff collaboration in low level residential aged care (assisted living) facilities in Australia as seen by the family carers of residents. Collaboration with the willing family is widely acknowledged to be important in the care of the older person. Previous work in nursing homes has shown that staff-family relationships are often ambiguous. Relatively little is known about the issue of staff-family relationships in assisted living facilities. Using qualitative methodology twelve family carers from five assisted living facilities were interviewed and transcripts analysed thematically. Data were collected in 2006/2007. Four factors important to the establishment and maintenance of collaborative staff-family relationships were identified: comfort, communication, consultation and confidence. Low level care facilities need to create environments that are conducive to the establishment and maintenance of constructive staff-family relationships. A number of practice considerations for care staff to foster relationship-centred care with the family in these types of facilities are presented.
    Keywords: Attitude of Health Personnel ; Cooperative Behavior ; Professional-Family Relations ; Assisted Living Facilities -- Organization & Administration ; Family -- Psychology ; Long-Term Care -- Organization & Administration
    ISSN: 03092402
    E-ISSN: 1365-2648
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  • 2
    In: Journal of Clinical Nursing, April 2010, Vol.19(7‐8), pp.1173-1174
    Description: To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1365-2702.2010.03202.x Byline: Michael Bauer
    Keywords: Elderly ; Hospital Admission And Discharge;
    ISSN: 0962-1067
    E-ISSN: 1365-2702
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  • 3
    Language: English
    In: Analytical chemistry, 19 June 2012, Vol.84(12), pp.5335-42
    Description: The first response to infection in the blood is mediated by leukocytes. As a result crucial information can be gained from a hemogram. Conventional methods such as blood smears and automated sorting procedures are not capable of recording detailed biochemical information of the different leukocytes. In this study, Raman spectroscopy has been applied to investigate the differences between the leukocyte subtypes which have been obtained from healthy donors. Raman imaging was able to visualize the same morphological features as standard staining methods without the need of any label. Unsupervised statistical methods such as principal component analysis and hierarchical cluster analysis were able to separate Raman spectra of the two most abundant leukocytes, the neutrophils and lymphocytes (with a special focus on CD4(+) T-lymphocytes). For the same cells a classification model was built to allow an automated Raman-based differentiation of the cell type in the future. The classification model could achieve an accuracy of 94% in the validation step and could predict the identity of unknown cells from a completely different donor with an accuracy of 81% when using single spectra and with an accuracy of 97% when using the majority vote from all individual spectra of the cell. This marks a promising step toward automated Raman spectroscopic blood analysis which holds the potential not only to assign the numbers of the cells but also to yield important biochemical information.
    Keywords: Spectrum Analysis, Raman ; Cell Separation -- Methods ; Lymphocytes -- Cytology ; Neutrophils -- Cytology
    ISSN: 00032700
    E-ISSN: 1520-6882
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  • 4
    Language: English
    In: Bipolar Disorders, May, 2012, Vol.14, p.37(14)
    Description: To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1399-5618.2012.00991.x Byline: Michael Bauer (a), Philipp Ritter (a), Heinz Grunze (b), Andrea Pfennig (a) Keywords: anticonvulsants; atypical antipsychotics; bipolar disorder; depression; lithium; pharmacotherapy; psychotherapy Abstract: Bauer M, Ritter P, Grunze H, Pfennig A. Treatment options for acute depression in bipolar disorder. Bipolar Disord 2012: 14 (Suppl. 2): 37-50. [c] 2012 The Authors. Journal compilation [c] 2012 John Wiley & Sons A/S. Objective: The burden of depression represents the most debilitating dimension for the majority of patients with bipolar disorder and dominates the long-term course of the illness. The purpose of this manuscript is to review the evidence base of the available treatment options for bipolar depression within two frequent clinical scenarios. Methods: The evidence is largely based on a systematic literature search and appraisal that was part of the development of the German Guideline for Bipolar Disorders. All relevant randomized controlled trials were critically evaluated. Results: Overall, the number of suitably controlled studies for the treatment of bipolar depression is relatively low. There are two common scenarios. Scenario A, if a patient with bipolar depression is currently not being treated with a mood-stabilizing agent (de novo depression, first or subsequent episode), then quetiapine or olanzapine are options, or alternatively, carbamazepine and lamotrigine can be considered. Antidepressants are an option for short-term use, but whether they are best administered as monotherapy or in combination with mood-stabilizing agents is still controversial. In practice, most clinicians use antidepressants in combination with an antimanic agent. Scenario B, if a patient is already being treated optimally with a mood-stabilizing agent (good adherence and appropriate dose) such as lithium, lamotrigine is an option. There is no evidence for additional benefit from antidepressants where a patient is already being treated with a mood stabilizer; however, in practice an antidepressant is often trialled. Efficient psychotherapy is an important part of the treatment regimen and should span all phases of the illness. Conclusions: Treatment decisions in bipolar depression involve a range of different pharmacological and non-pharmacological options. Monitoring potential unwanted effects and the appropriateness of treatment can help to effectively balance benefits and risks in individual situations. However, the quality of the assessment and reporting of risks in clinical trials need to be improved to better inform treatment decisions. Author Affiliation: (a)Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universitat Dresden, Dresden, Germany (b)Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK Article History: Received 8 August 2011, revised and accepted for publication 22 October 2011 Article note: Corresponding author: , Michael Bauer, M.D., Ph.D. , Department of Psychiatry and Psychotherapy , Carl Gustav Carus University Hospital , Technische Universitat Dresden , Fetscherstra[sz]e 74 , 01307 Dresden, Germany , Fax: +49 (0)351 458 4324 , E-mail: michael.bauer@uniklinikum-dresden.de
    Keywords: Bipolar Disorder -- Care And Treatment ; Bipolar Disorder -- Drug Therapy ; Carbamazepine ; Olanzapine ; Psychotherapy ; Antidepressants ; Tricyclic Antidepressants ; Antipsychotic Agents
    ISSN: 1398-5647
    Source: Cengage Learning, Inc.
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  • 5
    Language: English
    In: Bipolar Disorders, May, 2012, Vol.14, p.37(14)
    Description: To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1399-5618.2012.00991.x Byline: Michael Bauer (a), Philipp Ritter (a), Heinz Grunze (b), Andrea Pfennig (a) Keywords: anticonvulsants; atypical antipsychotics; bipolar disorder; depression; lithium; pharmacotherapy; psychotherapy Abstract: Bauer M, Ritter P, Grunze H, Pfennig A. Treatment options for acute depression in bipolar disorder. Bipolar Disord 2012: 14 (Suppl. 2): 37-50. [c] 2012 The Authors. Journal compilation [c] 2012 John Wiley & Sons A/S. Objective: The burden of depression represents the most debilitating dimension for the majority of patients with bipolar disorder and dominates the long-term course of the illness. The purpose of this manuscript is to review the evidence base of the available treatment options for bipolar depression within two frequent clinical scenarios. Methods: The evidence is largely based on a systematic literature search and appraisal that was part of the development of the German Guideline for Bipolar Disorders. All relevant randomized controlled trials were critically evaluated. Results: Overall, the number of suitably controlled studies for the treatment of bipolar depression is relatively low. There are two common scenarios. Scenario A, if a patient with bipolar depression is currently not being treated with a mood-stabilizing agent (de novo depression, first or subsequent episode), then quetiapine or olanzapine are options, or alternatively, carbamazepine and lamotrigine can be considered. Antidepressants are an option for short-term use, but whether they are best administered as monotherapy or in combination with mood-stabilizing agents is still controversial. In practice, most clinicians use antidepressants in combination with an antimanic agent. Scenario B, if a patient is already being treated optimally with a mood-stabilizing agent (good adherence and appropriate dose) such as lithium, lamotrigine is an option. There is no evidence for additional benefit from antidepressants where a patient is already being treated with a mood stabilizer; however, in practice an antidepressant is often trialled. Efficient psychotherapy is an important part of the treatment regimen and should span all phases of the illness. Conclusions: Treatment decisions in bipolar depression involve a range of different pharmacological and non-pharmacological options. Monitoring potential unwanted effects and the appropriateness of treatment can help to effectively balance benefits and risks in individual situations. However, the quality of the assessment and reporting of risks in clinical trials need to be improved to better inform treatment decisions. Author Affiliation: (a)Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universitat Dresden, Dresden, Germany (b)Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK Article History: Received 8 August 2011, revised and accepted for publication 22 October 2011 Article note: Corresponding author: , Michael Bauer, M.D., Ph.D. , Department of Psychiatry and Psychotherapy , Carl Gustav Carus University Hospital , Technische Universitat Dresden , Fetscherstra[sz]e 74 , 01307 Dresden, Germany , Fax: +49 (0)351 458 4324 , E-mail: michael.bauer@uniklinikum-dresden.de
    Keywords: Bipolar Disorder -- Care And Treatment ; Bipolar Disorder -- Drug Therapy ; Carbamazepine ; Olanzapine ; Psychotherapy ; Antidepressants ; Tricyclic Antidepressants ; Antipsychotic Agents
    ISSN: 1398-5647
    Source: Cengage Learning, Inc.
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  • 6
    Language: English
    In: Australian & New Zealand Journal of Psychiatry, November 2012, Vol.46(11), pp.1068-1078
    Description: Objective: Most patients with bipolar disorder experience depressive symptoms outside of an episode of depression as defined by DSM-IV criteria. This study explores the frequency of brief depressive episodes, lasting 1 to 4 days, using daily self-reported mood ratings. Method: Mood ratings were obtained from 448 patients (281 bipolar I, 167 bipolar II) using ChronoRecord software (91,786 total days). Episodes of depression and days of depression outside of episodes were determined. The intensity of depressive symptoms (mild versus moderate to severe) was compared. Results: Using the DSM-IV length criteria, 61% of all depressive days occurred outside of a depressed episode. Decreasing the minimum length criterion to 2 days, both the number of patients experiencing a depressed episode (128 to 317) and the mean percent of days spent in a depressed episode by each patient (7.9% to 17.8.%) increased by about 2½ times, and 34.3% of depressed days remained outside of an episode. Depending on the episode length, the proportion of days within an episode with severe symptoms varied from ⅓ to ¼ for episodes lasting from 14 to 2 days, and ¼ for single-day episodes. There was no significant difference in the frequency of brief depressive episodes between bipolar I and II disorders. For all episode lengths, patients taking antidepressants spent 4% more days within an episode and 6% more days with depressive symptoms outside of an episode than those not taking antidepressants. Conclusion: Brief depressive episodes lasting 1 to 4 days occur frequently in bipolar disorder and do not distinguish between bipolar I and II disorders. Symptoms of moderate to severe intensity occur on ¼ to ⅓ of the days in brief depressive episodes. This study did not address brief depression in those without bipolar disorder. Patients taking antidepressants experienced more brief depressive episodes. Controlled trials are needed to assess the impact of antidepressants on subsyndromal depressive symptoms.
    Keywords: Bipolar Disorder ; Brief Depressive Episode ; Subsyndromal Symptoms ; Medicine
    ISSN: 0004-8674
    E-ISSN: 1440-1614
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  • 7
    Language: English
    In: Journal of advanced nursing, October 2015, Vol.71(10), pp.2224-36
    Description: To report a meta-synthesis of qualitative research studies exploring the role of nursing home staff in decisions to transfer residents to hospital. Nurses and nurse assistants provide the majority of care to residents living in nursing homes and may be the only health workers present when a resident deteriorates. To inform future strategies, it is vital to understand the role of nursing home staff in decisions to transfer to hospital. A systematic review identified 17 studies to be included. The process of meta-synthesis was undertaken using the Joanna Briggs Institute's guidelines. Qualitative research papers published between January 1989-October 2012 were identified in key databases including Cinahl, Embase, Medline and PsycInfo. Nursing home staff members play a key role in decision-making at the time of a resident's deterioration. Multiple factors influence decisions to transfer to hospital including an unclear expectation of the nursing home role; limited staffing capacity; fear of working outside their scope of practice; poor access to multidisciplinary support and difficulties communicating with other decision-makers. There is a lack of consensus regarding the role of the nursing home when a resident's health deteriorates. Nursing home staff would benefit from a clear prescription of their expected minimum clinical skill set; a staffing capacity that allows for the increased requirements to manage residents on-site, greater consistency in access to outside resources and further confidence and skills to optimize their role in resident advocacy.
    Keywords: Decision-Making ; Hospital Care ; Hospitalization ; Literature Review ; Nurses ; Nursing Homes ; Patient Transfer ; Qualitative Research ; Systematic Review ; Clinical Decision-Making ; Nursing Homes ; Nursing Staff -- Psychology ; Patient Transfer -- Methods
    ISSN: 03092402
    E-ISSN: 1365-2648
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  • 8
    In: Journal of Advanced Nursing, June 2011, Vol.67(6), pp.1232-1241
    Keywords: Aged Care ; Assisted Living ; Family Carers ; Residential Care ; Staff–Family Relationships
    ISSN: 0309-2402
    E-ISSN: 1365-2648
    Source: John Wiley & Sons, Inc.
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  • 9
    Language: English
    In: Pediatrics, September 2010, Vol.126(3), pp.484-9
    Description: The goal was to examine the association between the New York State (NYS) upgraded child restraint law (UCRL) implemented in 2005 and the traffic injury rate among 4- to 6-year-old children in New York State. A before/after comparison study of population-based, traffic injury rates for 4- to 6-year-old children, using 0- to 3-year-old children as a comparison group, was performed. The effects of UCRL on injury rates among 0- to 3-year-old and 4- to 6-year-old motor vehicle passengers were estimated by using monthly injury count data from the NYS Department of Motor Vehicles Accident Information System. Children 4 to 6 years of age experienced an 18% reduction in traffic injury rate (adjusted rate ratio [aRR]: 0.82 [95% confidence interval [CI]: 0.79-0.85]) after UCRL implementation, whereas the injury rate for children 0 to 3 years of age, who were not directly affected by the UCRL, did not change appreciably (aRR: 0.95 [95% CI: 0.90-0.99]). In Poisson regression analysis, the aRR for injury for 4- to 6-year-old children was 1.06 (95% CI: 0.92-1.22]) with adjustment for monthly child restraint use rates, which reveals that the significant reduction in the injury rate among 4- to 6-year-old children was mainly attributable to the 72% increase in the child restraint use rate after UCRL implementation (from 29% before UCRL implementation to 50% after implementation). This is the first study comparing traffic injury rates for booster seat-aged children before and after implementation of the booster seat law in a single state.
    Keywords: Accidents, Traffic -- Legislation & Jurisprudence ; Child Restraint Systems -- Standards ; Wounds and Injuries -- Epidemiology
    ISSN: 00314005
    E-ISSN: 1098-4275
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  • 10
    Language: English
    In: Journal of Affective Disorders, 2010, Vol.127(1), pp.19-30
    Description: Two positive studies evaluated adjunctive extended release quetiapine fumarate (quetiapine XR) in patients with major depressive disorder (MDD) showing inadequate response to antidepressant treatment. This preplanned, pooled analysis provides an opportunity for subgroup analyses investigating the influence of demographic and disease-related factors on observed responses. Additional post hoc analyses examined the efficacy of quetiapine XR against specific depressive symptoms including sleep. Data were analysed from two 6-week, multicentre, double-blind, randomised, placebo-controlled studies, prospectively designed to be pooled. Patients received once-daily quetiapine XR 150 mg/day ( = 309), 300 mg/day ( = 307) or placebo ( = 303) adjunctive to ongoing antidepressant therapy. The primary endpoint was change from randomisation to Week 6 in MADRS total score. Other assessments included MADRS response (≥ 50% decrease in total score) and remission (total score ≤ 8), change from randomisation in HAM-D, HAM-A, PSQI global and CGI-S scores. Quetiapine XR (150 and 300 mg/day) reduced MADRS total scores vs placebo at every assessment including Week 6 (− 14.5, − 14.8, − 12.0; 〈 0.001 each dose) and Week 1 (− 7.8,−7.3,−5.1; 〈 0.001 each dose). For quetiapine XR 150 and 300 mg/day and placebo, respectively at Week 6: MADRS response 53.7% ( = 0.063), 58.3% ( 〈 0.01) and 46.2%; MADRS remission 35.6% ( 〈 0.01), 36.5% ( 〈 0.001) and 24.1%. Quetiapine XR 150 and 300 mg/day significantly improved HAM-D, HAM-A, PSQI and CGI-S scores at Week 6 vs placebo. Quetiapine XR demonstrated broad efficacy, independent of factors including concomitant antidepressant. Fixed dosing; lack of active comparator. Adjunctive quetiapine XR is effective in patients with MDD and an inadequate response to antidepressant therapy, with improvement in depressive symptoms seen as early as Week 1.
    Keywords: Extended Release ; Quetiapine ; Adjunctive ; Major Depressive Disorder
    ISSN: 0165-0327
    E-ISSN: 1573-2517
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