Saturday, March 31, 2012

Abbreviated PTSD Checklist (PCL) as a guide to clinical response.




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Abbreviated PTSD Checklist (PCL) as a guide to clinical response.



Gen Hosp Psychiatry. 2012 Mar 26;
Lang AJ, Wilkins K, Roy-Byrne PP, Golinelli D, Chavira D, Sherbourne C, Rose RD, Bystritsky A, Sullivan G, Craske MG, Stein MB

OBJECTIVE: The objective of this study was to evaluate two abbreviated versions of the PTSD Checklist (PCL), a self-report measure of posttraumatic stress disorder (PTSD) symptoms, as an index of change related to treatment. METHOD: Data for this study were from 181 primary care patients diagnosed with PTSD who enrolled in a large randomized trial. These individuals received a collaborative care intervention (cognitive behavioral therapy (CBT) and/or medication) or usual care and were followed 6 and 12 months later to assess their symptoms and functioning. The sensitivity of the PCL versions (i.e., full, two-item, six-item), correlations between the PCL versions and other measures, and use of each as indicators of reliable and clinically significant change were evaluated. RESULTS: All versions had high sensitivity (.92-.99). Correlations among the three versions were high, but the six-item version corresponded more closely to the full version. Both shortened versions were adequate indicators of reliable and clinically significant change. CONCLUSION: Whereas prior research has shown the two-item or six-item versions of the PCL to be good PTSD screening instruments for primary care settings, the six-item version appears to be the better alternative for tracking treatment-related change.








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Malignant fungating wounds - The meaning of living in an unbounded body.



Eur J Oncol Nurs. 2012 Mar 27;
Probst S, Arber A, Faithfull S

BACKGROUND: Malignant fungating wounds may have significant physiological, psychological and emotional consequences on patients and their families. This study focuses on understanding the lived experiences of patients with a malignant fungating breast wound and their informal carers. METHOD: The methodological framework of interpretative phenomenological approach according to Heidegger was used. Nine patients were interviewed from January until November 2009. RESULTS: The results demonstrate that most of the patients and their informal carers were on their own while struggling with the erosion of their physical boundaries. The women report a lack of information and advice about how to manage the wound as well as the physical and social limitations imposed on them because of copious wound exudate, odour and bleeding. The women used many different methods and approaches to maintain the boundedness of the body. CONCLUSION: This study contributes to understanding that losing control over the body meant for the women losing control over themselves and their lives. The unboundedness was demonstrated through the symptom experiences. Therefore the care of women needs strategies that are integrated in a palliative, holistic, empathic approach. In particular skills for palliative wound care among medical and nursing staff need to be developed as the women and their carers report a lack of information and advice about how to manage the wound as well as the physical limitations and psychosocial consequences of struggling to maintain the boundedness of the body.








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Effects of lenses with different power profiles on eye shape in chickens.



Vision Res. 2012 Feb 1; 54: 12-9
Tepelus TC, Vazquez D, Seidemann A, Uttenweiler D, Schaeffel F

Defocus imposed to the periphery of the visual field can affect the development of foveal/central refractive errors. To make use of this observation, lenses can be designed to reduce myopia progression, but it is important to know which power profiles of the lenses are most effective. We have studied this question in chickens.Sixty male white leghorn chickens were used. From day 7 after hatching, they were treated for 5 days either with full field -7D or +7D lenses, with -7D lenses with a 4mm central hole, with hemi-field lenses of the same power, or with two different types of radial refractive gradient (RRG) lenses with increasing positive power from the center to the periphery, which were designed by Rodenstock GmbH, Munich, Germany. A macro file was written for "ImageJ" to trace and average the outlines of several excised eyes after treatment. Shapes of fellow control eyes and lens-treated eyes were compared in the horizontal and vertical meridians. Refractions were determined at -45°, 0°, and 45° over the horizontal visual field, at the beginning and at the end of experiments, using automated infrared photoretinoscopy.(1) Eye length, as determined by the new automated eye shape tracing technique, was well correlated with A-scan ultrasound data. (2) The effects of previously tested lens designs were reproduced with the new tracing technique. Full field lenses were by far the most effective (-7D: external axial length +0.24mm with an increase in eye volume of about 6%, +7D: -0.08 mm, with a decrease in eye volume of about 2%). Hemi-field lenses and negative lenses with a 4mm central hole induced conspicuous local changes in eye shape. (3) The first type of RRG lenses with a plano zone of about 4mm (equivalent to about ± 12.52° in the visual field for a vertex distance of 5mm) had no apparent effect on central refractions but induced small hyperopic shifts in the periphery, more significant in the temporal retina (+1.70 ± 1.70 D, p<0.001, paired t-test to untreated fellow eyes). The second type of RRG lenses with a small plano zone of 2mm (equivalent to ± 6.34°) induced peripheral hyperopia but also changed the central refraction (temporal retina +1.50 ± 1.17D, p<0.001, central retina +0.77 ± 1.15 D, p<0.01, nasal retina +1.47±1.35D, p<0.001, paired t-test to untreated control eyes).In the afoveate chick, RRG lenses have an effect on central refraction and eye growth only if the central plano zone is small (<4mm). For the second type of RRG lens with a central plano zone of about 2mm, inhibitory effects on eye growth were detected in both the center and periphery even though the optical power of the lenses in the periphery was low.







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