Measuring Attitudes of Mental Health Care Staff Toward Suicidal Patients

Measurement, because of its role in the scientific process, is one of the principal concerns in human sciences. This study investigates three measurement instruments for attitudes of mental health care staff toward suicidal patients in terms of their dimensionality and the validity and reliability of the individual indicators: the instruments designed by Suokas & Lönnqvist (1989), Samuelsson, Åsberg & Gustavsson (1997) and by Ramberg and Wasserman. The empirical analyses are done with LISREL, a structural equation modeling approach that is particularly useful to study measurement instruments for abstract concepts. This approach provides an explicit test of the dimensionality of a construct and of the validity of each the indicators. It also gives explicit information on measurement error in the observed variables. The results show that each measurement instrument contains several components as hypothesised, but only some of them, tested as confirmatory factor analysis models, produced a good fit. Moreover the validity and the reliability of their indicators varied considerably. Empathy was the most consistently measured component in the three measurement instruments.     

Benefits of Implementing an Academic Training of Trainers Program to Promote Knowledge and Clarity in Work with Psychiatric Suicidal Patients

A 200-hour academic, postgraduate training-of-trainers program in suicide prevention at Karolinska Institute for key mental healthcare staff, designed to enable them to enhance their co-workers’ knowledge and job clarity, was evaluated in a panel study by means of questionnaires. Psychiatric staff working regularly with suicidal patients in clinics where key persons attended the course (n = 134, intervention group) were compared with staff working in clinics without participants (n = 166, control group). Perceptions of being sufficiently trained (p < .01) improved significantly among staff working in intervention clinics. Compared with the control group, the intervention group had a better understanding of essentials (p < .05); found instructions clearer (p < .01) and experienced fewer problems with superiors’ differing views (p < .05) at follow up. Assistant nurses working in intervention clinics seem to have benefited most.     

Occupational allergic contact dermatitis from alkanolamineborates in metalworking fluids

Alkanolamineborates are extensively used in coolants as corrosion inhibitors. In this paper, 3 machinists with contact allergy to alkanolamineborates are reported. To avoid false-positive test reactions due to the alkalinity of the alkanolamineborates, they should be tested when dissolved in an acidic buffer. When various alkanolamineborates were tested in dilution series in the 3 patients, 2 types of reactivity patterns emerged, indicating the existence of at least 2 separate sensitizers in alkanolamineborates. The raw materials, ethanolamines and boric acid, did not yield any positive patch test reactions. Thin-layer chromatography investigations demonstrated that each alkanolamineborate consists of many substances, which differed in part between different alkanolamineborates. The present study shows that it is not possible to use 1 particular alkanolamineborate for tracing contact allergy to alkanolamineborates in general.     

Comparative Cardiovascular Effects of the Angiotensin II Type 1 Receptor Antagonists ZD 7155 and Losartan in the Rat

Binding experiments show that ZD 7155 is a potent angiotensin II type 1 receptor antagonist. In this study this novel substance was studied in normotensive and hypertensive rats. The relative potency and duration of the antihypertensive effects of ZD 7155 were compared with those of the reference substance, losartan. The inhibitory effects of both compounds on angiotensin II-induced pressor actions were studied in the conscious normotensive Sprague-Dawley (SD) rat and in the conscious, spontaneously hypertensive rat (SHR). Arterial blood pressure and heart rate (HR) were obtained by direct intraarterial recording. Angiotensin II infusion was administered intravenously in the dose range 53.3 ng—12.8 μg kg^?1 min^?1 to the conscious rats. ZD 7155 was administered in a bolus dose of 1.082 μmol kg^?1 (0.51 mg kg^?1) and losartan in bolus doses of 2.165 and 6.495 μmol kg^?1 (1.0 and 3.0 mg kg^?1). In conscious SD rats, ZD 7155 and losartan behaved as competitive antagonists and the pressor response curve to angiotensin II was shifted to the right. Experiments in conscious SD rats also showed that ZD 7155 was approximately ten times as potent as losartan in suppressing the angiotensin II-induced pressor response (240 ng kg^?1; 10 min infusion). In addition, experiments with conscious rats demonstrated that ZD 7155 could suppress the angiotensin II-induced pressor response for approximately 24 h when ZD 7155 was administered intravenously in a 1.082 μmol kg^?1 bolus dose and angiotensin II was given at 240 ng kg^?1 (in a 10?min infusion). Experiments in conscious SHRs using ZD 7155 (1.082 μmol kg^?1) and losartan (6.495 μmol kg^?1) as intravenous boluses indicated that both ZD 7155 and the reference compound losartan exhibited a significant antihypertensive effect. These results demonstrate that ZD 7155 is a potent angiotensin II-type 1 antagonist which is approximately ten times as potent as losartan in suppressing the angiotensin II-induced pressor response. Furthermore, ZD 7155 may suppress the angiotensin II-induced pressor response for 24 h and in the SHR ZD 7155 induces a pronounced and persistent antihypertensive effect.     

The pre-B-cell receptor

The pre-B-cell receptor (pre-BCR) is composed of two immunoglobulin mu heavy chains and two surrogate light chains, which associate with the signaling molecules Igalpha and Igbeta (Igalpha/beta). The production of a functional pre-BCR is the first checkpoint in the current model of B-cell development. The pre-BCR mediates signals resulting in heavy chain allelic exclusion, down-regulation of the recombination machinery, developmental progression, V(H) repertoire selection, proliferation and down-regulation of the surrogate light chain genes. Recent studies suggest that some of these processes could take place at an earlier stage in B-cell development than previously thought, and might not result from signals mediated by the pre-BCR.     

Policies concerning assistive technology and home modification services for people with physical and cognitive disabilities in Sweden

The purpose of this paper is to describe policies, laws and regulations regarding the procurement of assistive technology and home modifications for individuals with disabilities in Sweden. Children up to ages 17-21 are entitled to free access to assistive technology. For adults the access is substantially subsidized with public funding. We will discuss the issues and implications of new technology, with an emphasis on assistive technology for cognitive impairment. Today, the social security system is financially burdened due to increasing demands and limited economic growth. However, the basic doctrine of the "Swedish model" remains, evoking structural and ethical issues.     

The first step in using a robot in brain injury rehabilitation: patients’ and health-care professionals’ perspective

Purpose: To evaluate the usability of a mobile telepresence robot (MTR) in a hospital training apartment (HTA). The MTR was manoeuvred remotely and was used for communication when assessing independent living skills, and for security monitoring of cognitively impaired patients. Method: Occupational therapists (OTs) and nurses received training in how to use the MTR. The nurses completed a questionnaire regarding their expectations of using the MTR. OTs and patients staying in the HTA were interviewed about their experiences of the MTR. Interviews and questionnaires were analysed qualitatively. Results: The HTA patients were very satisfied with the MTR. The OTs and nurses reported generally positive experiences. The OT’s found that assessment via the MTR was more neutral than being physically present. However, the use of the MTR implied considerable difficulties for health-care professionals. The main obstacle for the nurses was the need for fast and easy access in emergency situations while protecting the patients’ integrity. Conclusions: The results indicate that the MTR could be a useful tool to support daily living skills and safety monitoring of HTA patients. However, when designing technology for multiple users, such as health-care professionals, the needs of all users, their routines and support services involved, should also be considered.

• Implications for Rehabilitation

• A mobile telepresence robot (MTR) can be a useful tool for assessments and communication in rehabilitation.

• The design of the robot has to allow easy use by remote users, particularly in emergency situations.

• When designing MTRs the needs of ALL users have to be taken into consideration.

     

CD99 expression is strongly associated with clinical outcome in children with B-cell precursor acute lymphoblastic leukaemia

Our study aimed to determine the expression pattern and clinical relevance of CD99 in paediatric B-cell precursor acute lymphoblastic leukaemia (BCP-ALL). Our findings demonstrate that high expression levels of CD99 are mainly found in high-risk BCP-ALL, e.g. BCR-ABL1 and CRLF2^Re/Hi_, and that high CD99 mRNA levels are strongly associated with a high frequency of relapse, high proportion of positive for minimal residual disease at day 29 and poor overall survival in paediatric cohorts, which indicate that CD99 is a potential biomarker for BCP-ALL.