Use of the Screening tool of older person's prescriptions (STOPP) in older people admitted to an Australian hospital

Aims: To determine the prevalence of potentially inappropriate medications (PIMs) in older people aged 65years and over who were admitted to hospital, and to examine the medications and medication classes that comprised these PIMs with use of the Screening Tool of Older Person's Prescriptions. Method: Using a retrospective clinical audit design, the medical records of 100 older patients were randomly selected and examined for the prevalence and characteristics of PIMs. The audit was undertaken of patients admitted over a 12-month period to an Australian public teaching hospital. Results: In total, 92 individual occurrences of PIMs were detected, and 54 patients had at least one PIM. The most common type of PIM experienced related to prescribed medications that adversely affected individuals who were prone to falls. Conclusion: Many older patients experienced a PIM during their hospital admission, where the risk of an adverse event could outweigh the clinical benefit.

Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi study

BACKGROUND: People who experience traumatic events have an increased risk of developing a range of mental disorders. Appropriate early support from a member of the public, whether a friend, family member, co-worker or volunteer, may help to prevent the onset of a mental disorder or may minimise its severity. However, few people have the knowledge and skills required to assist. Simple guidelines may help members of the public to offer appropriate support when it is needed.

METHODS: Guidelines were developed using the Delphi method to reach consensus in a panel of experts. Experts recruited to the panels included 37 professionals writing, planning or working clinically in the trauma area, and 17 consumer or carer advocates who had been affected by traumatic events. As input for the panels to consider, statements about how to assist someone who has experienced a traumatic event were sourced through a systematic search of both professional and lay literature. These statements were used to develop separate questionnaires about possible ways to assist adults and to assist children, and panel members answered either one questionnaire or both, depending on experience and expertise. The guidelines were written using the items most consistently endorsed by the panels across the three Delphi rounds.

RESULTS: There were 180 items relating to helping adults, of which 65 were accepted, and 155 items relating to helping children, of which 71 were accepted. These statements were used to develop the two sets of guidelines appended to this paper.

CONCLUSIONS: There are a number of actions which may be useful for members of the public when they encounter someone who has experienced a traumatic event, and it is possible that these actions may help prevent the development of some mental health problems in the future. Positive social support, a strong theme in these guidelines, has some evidence for effectiveness in developing mental health problems in people who have experienced traumatic events, but the degree to which it helps has not yet been adequately demonstrated. An evaluation of the effectiveness of these guidelines would be useful in determining their value. These guidelines may be useful to organisations who wish to develop or revise curricula of mental health first aid and trauma intervention training programs and policies. They may also be useful for members of the public who want immediate information about how to assist someone who has experienced a potentially traumatic event.

Expert in my pocket: creating first person POV videos to enhance mobile learning

Worldwide, there has been a rapid increase in both the use of mobile technologies as a conduit for student learning and the use of wearable cameras to record sporting and recreational activities. The Expert in My Pocket project (EiMP) has combined these two technologies to produce a repository of freely available short videos and supporting materials to enhance student development of psychomotor clinical skills. The videos are presented from a first person point of view (1PPOV) with expert health professionals ‘thinking aloud’ as they demonstrate selected skills. Research indicates that students and educators overwhelmingly support the concept of EiMP videos and more importantly value the 1PPOV as an authentic view. This paper demonstrates the techniques and equipment employed to produce these videos, which consisted of a chest or head mounted GoPro camera operated via an iPad. Additionally, the paper explains another innovative feature, Quick Response (QR) Codes, that when linked to the videos placed on equipment assists with “just in time” mobile learning.

Perspective taking and empathy: does having similar past experience to another person make it easier to take their perspective?

This study tested the hypothesis that it is easier to take the perspective of another person when one has similar past experience. Volunteer participants (N = 154) were asked to take the perspective of a protagonistin one of four problematic interpersonal situations and then to rate the ease with which they felt able to perspective take and the extent of their personal past experience of similar situations. Similar past experiencepredicted ease of perspective taking, with the relationship influenced by reflection on past experience. Ease of perspective taking mediated the relationship between similar past experience and participant perceptionsof their accuracy in understanding the other person, but ease was not associated with emotional arousal. The findings have potential therapeutic applications for attempts to increase empathy and understanding in people for whom perspective taking may be difficult.

Translating person-centered care into practice: a comparative analysis of motivational interviewing, illness-integration support, and guided self-determination

OBJECTIVE: Person-centred care [PCC] can engage people in living well with a chronic condition. However, translating PCC into practice is challenging. We aimed to compare the translational potentials of three approaches: motivational interviewing [MI], illness integration support [IIS] and guided self-determination [GSD]. METHODS: Comparative analysis included eight components: (1) philosophical origin; (2) development in original clinical setting; (3) theoretical underpinnings; (4) overarching goal and supportive processes; (5) general principles, strategies or tools for engaging peoples; (6) health care professionals' background and training; (7) fidelity assessment; (8) reported effects. RESULTS: Although all approaches promoted autonomous motivation, they differed in other ways. Their original settings explain why IIS and GSD strive for life-illness integration, whereas MI focuses on managing ambivalence. IIS and GSD were based on grounded theories, and MI was intuitively developed. All apply processes and strategies to advance professionals' communication skills and engagement; GSD includes context-specific reflection sheets. All offer training programs; MI and GSD include fidelity tools. CONCLUSION: Each approach has a primary application: MI, when ambivalence threatens positive change; IIS, when integrating newly diagnosed chronic conditions; and GSD, when problem solving is difficult, or deadlocked. PRACTICE IMPLICATIONS: Professionals must critically consider the context in their choice of approach.

Between freedom and reclusion: Social support as a quality-of-life component in the family caregiver-dependent person binomial

This is a qualitative study which uses Grounded Theory as its methodological framework and Symbolic Interactionism as a theoretical base to understand the experience of family caregivers for Cerebrovascular Accident (CVA) patients with regard to social support during their rehabilitation process at home. The components (themes and categories) of the phenomenon assuming home care and specifically the themes assuming care with support and assuming care without support were inter-related for the purpose of comparison and analysis, in order to apprehend how the interaction between them occurred, It was observed that, in addition to the recovery of the patient's autonomy, social support is one of the intervenient components in the quality of life for the family caregiver-disabled person binomial, particularly with respect to the caregiver's freedom to resume his/her life plan.

Tonsilar metastases of melanoma in an older person

We presented a rare case of metastasis of melanoma in palatine tonsils alerting healthcare professionals to this diagnose in black oral lesions. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

Person centered psychotherapy: an encounter with oneself or a confrontation with the other?

O artigo discute a possibilidade do acolhimento da Alteridade no processo terapêutico da Abordagem Centrada na Pessoa. Tem-se como referência a ética de Emmanuel Lévinas, para quem a subjetividade seria constituída a partir da relação com o absolutamente outro. Questiona-se o processo de mudança terapêutica que visa uma maior integração da experiência pelo self. Em direção distinta, a partir de uma releitura de um caso clínico rogeriano, aponta-se a exterioridade da experiência como estranhamento que permite uma recriação de si. O relato analisado mostra a interioridade ser solapada pelo organismo que se coloca como um outro-de-si, crivo para as experiências. Conclui-se que a psicoterapia centrada na pessoa, além de um encontro consigo mesmo, parece apontar como um de seus efeitos o embate com o radicalmente diferente. Tal discussão alude a um reposicionamento político da Abordagem Centrada na Pessoa em sua lida com a diferença.

The importance of parental involvement in swimming lessons for person with disability

The Ecolological Theory of Human Development proposed by Urie Bronfenbrenner assumes that the activities and people involved in an evironment are essential to stimulate the aquisition of new abilities . Analyze the strategy of parent’s presence with their children in a swimming class for PWD during the teaching process. Also, verify the parent’s views on this experience and the participation of their child during practice. It is a qualitative and action-research. To collect data was utilized observation during to analyse the activities developed in a swimming class for PWD, on the presence of parents with their children. A semi-structured interview was used to analyse the perception parents after the experience of the classroom. Analysis of activities and the interview were based on the assumption of Bronfenbrenner (1996). It was found that 100% of the parents rated the positive experience of being with their children in the pool. We found that only 25% of parents reported that had entered the pool to play with their children. We emphasize that 75% had never entered in the water with their children, whether because of fear, lack of opportunity or not knowing how to swim. The proposal of parents’ participation in the swimming class with the PWD generated a favorable environment for development the activities. Parents identified the improvement, the potential and difficulties of PWD.

The tale of a person and a peptide: Wylie W. Vale Jr. and the role of corticotropin- releasing factor in the stress response

The studies reviewed in this article certainly do not constitute the entire body of research conducted by Wylie Vale's group and his collaborators, they might constitute turning points in CRF research. In addition, the studies reviewed here show that, over the course of 31 years (from 1981 to 2012), Wylie tirelessly pursued the answers to fundamental questions regarding CRF. He was a man whose drive never seemed to falter

Aumentare la realta' aumentata: il caso del First-Person Shooter Game sul Conte Luigi Ferdinando Marsili

Questa trattazione verterà sull'analisi di un sistema di gioco tra due individui, tra loro interagenti mediante handeld device, in un contesto immersivo posto in un luogo chiuso di natura museale. L'intera struttura, sviluppata nell'ambito del Corso di Sistemi ed Applicazioni Multimediali nell'anno 2010-2011, vuole porre un'innovazione rispetto agli scenari esistenti: laddove un'interazione museale richieda spesso la staticità dell'utilizzatore del servizio, il mezzo del gioco richiede invece la manipolazione e il movimento all'interno del luogo, garantendo un coinvolgimento maggiormente accentuato rispetto alla normale fruizione dei contenuti. Inoltre, la scelta alla base della realizzazione realizzazione si affida allo strumento multimediale e sempre più diffuso costituito dalle tecniche di Realtà Aumentata, che appongono aggiunte digitali all'ambiente circostante e permettono di modellare strutture d'informazione e manipolazione percepibili solo tramite apposite interfacce, ma pienamente inserite in un tessuto reale. La componente innovativa in questo schema è però portata da un'ulteriore aspetto, quello della cooper- azione di due dispositivi in contemporanea attori dell'interazione che, attraverso l'azione sulle informazioni esistenti, consentono di produrre modifiche rilevabili da ciascuno dei coinvolti.