Enabling the return-to-work process among people with affective disorders: A multiple-case study

Background: The Individual Enabling and Support (IES) model is an adapted, supported employment program developed to meet motivational, cognitive and time-use needs of people with affective disorders. Vocational programs for this target group have been developed but more knowledge is needed about the important characteristics and perceived usefulness of the programs. The aim of this study was to illustrate the IES model and process from multiple perspectives.

Methods: Five participants were included in this multiple-case study. The material comprised interviews with participants, intervention documents, memos and interviews with employment specialists. Within and cross-case analyzes and an analytical generalization were performed.

Results: The cases illustrated different IES processes, and the theme; Enabling engagement in return to work (RTW) was formulated. Continuous support from the employment specialist and a focus on personal resources and motivation were essential to overcome low self-confidence regarding RTW. Motivational, cognitive and time-use strategies gave an opportunity to learn new behavior and coping strategies for job seeking, getting employed and working.

Conclusion: Providing a combination of these strategies integrated with supported employment could promote self-efficacy and engagement in the RTW process among people on sick leave due to an affective disorder.     

Medical oath: use and relevance of the Declaration of Geneva. A survey of member organizations of the World Medical Association (WMA)

The Declaration of Geneva is one of the core documents of medical ethics. A revision process was started by the World Medical Association (WMA) in 2016. The WMA has also used this occasion to examine how the Declaration of Geneva is used in countries throughout the world by conducting a survey of all WMA constituent members. The findings are highly important and raise urgent questions for the World Medical Association and its National Medical Associations (NMA): The Declaration of Geneva is only rarely used as an oath text despite the fact that physicians’ oaths are generally widespread. This is not consistent with the intention and claim of the Declaration of Geneva. The article then discusses three questions. Should there be one single binding oath? Which organization should be responsible for such an oath? Which oath is the most obvious candidate? In a globalized world and despite all cultural diversity, the medical profession should have one core moral basis which is binding for physicians all over the world. The most obvious candidate for an oath incorporating this moral basis is the Declaration of Geneva.     

Idiopathische Hirnnervenausfälle

Cranial nerve lesions require a thorough diagnostic work-up and known etiologies have to be excluded before the term idiopathic can be considered. The focus of the present review is on idiopathic peripheral facial nerve paralysis (Bell’s palsy) for which this terminology has been established. For all other cranial nerve lesions the typical clinical signs, established etiologies and possible diagnostic pitfalls are discussed.     

Bleeding from gastrointestinal angioectasias is not related to bleeding disorders - a case control study

Background  

Angioectasias in the gastrointestinal tract can be found in up to 3% of the population. They are typically asymptomatic but may sometimes result in severe bleeding. The reasons for why some patients bleed from their angioectasias are not fully understood but it has been reported that it may be explained by an acquired von Willebrand syndrome (AVWS). This condition has similar laboratory findings to congenital von Willebrand disease with selective loss of large von Willebrand multimers. The aim of this study was to find out if AVWS or any other bleeding disorder was more common in patients with bleeding from angioectasias than in a control group.     

Hypothermie und ihr Einfluss auf das Tumorwachstum

Zeitschrift für Herz-,Thorax- und Gefäßchirurgie - Abhängig vom Ausmaß der vorliegenden Erkrankung und des chirurgischen Eingriffs erfordern Operationen an der thorakalen...     

Effect of small bowel resection on the intestinal surface acid microclimate in the rat

The effect of extensive (65%) proximal and middle small bowel resection on the intestinal surface acid microclimate (ISAM) of the remaining ileum in the rat was examined and the results were compared to those of sham-operated rats. ISAM pH measurements were performed in vivo using a pH microelectrode; incubation was performed in Krebs-Ringer phosphate buffer (pH 7.40 +/- 0.02). In the resected rats, ISAM pH of 6.03 +/- 0.07 and 7.22 +/- 0.03 were recorded in the proximal and distal part of the remaining ileum, respectively. In the sham-operated rats, ISAM pH of 6.04 +/- 0.07, 6.98 +/- 0.03 and 7.28 +/- 0.02 were recorded in the proximal jejunum and in the proximal and distal part of the corresponding ileal segment. ISAM pH was significantly lower (p less than 0.01) in the proximal part of the remaining ileum of the resected rats as compared to the corresponding part in the sham-operated rats but was similar in distal ileum. In fact, the ISAM pH of the proximal part of the remaining ileum of resected rats was as acidic as that of the jejunum of the sham-operated rats. These results clearly demonstrate that adaptation in the ISAM occurs in the remaining ileum following extensive resection of proximal and middle small intestine.