Constructing a positive identity: A qualitative study of the driving forces of peer workers in mental health‐care systems

There is growing recognition in mental health for the perspective of individuals with lived experience of mental health problems and mental health service use. As peer workers, these individuals can use their specific experience to benefit and support peers and professional caregivers, and to participate at all levels of mental health‐care systems. The aim of the present study was to develop a conceptual framework representing the driving forces of peer workers to fullfil their position in mental health‐care systems. A qualitative interview approach was employed using principles of grounded theory. Over a period of 5 months in 2014–2015, semistructured interviews were conducted with 14 peer workers in residential and community mental health‐care systems. The emerged conceptual framework reveals that peer workers strive towards constructing a positive identity. This process is powered by driving forces reflecting a desire for normalization and an urge for self‐preservation. Peer workers realize a meaningful employment by using their lived experience perspective as an asset, liberating themselves out of restrictive role patterns, and by breaking down stigma and taboo. As a precondition to engage in these normalization processes, peer workers perceive they need to secure their self‐preservation by balancing the emergence of adverse emotional fluctuations. The conceptual framework can inform the development of work contexts in which peer workers have an authentic and meaningful contribution, while being offered sufficient support and learning opportunities to manage their well‐being.     

More than preparing a meal? Concerning the meanings of home cooking

Cooking is one of the basic activities in our lives. However, people frequently feel they fall short of time to cook when facing problems with the temporal organization of daily life. How people think about home cooking is considered to be important for the time they spend on preparing meals. It is assumed that the meaning of cooking differs for different people, depending on the temporal and social context. This contribution allows us to clarify how the meaning of cooking varies according to individual and household characteristics and the cooking occasion. By using the pooled time-diary data from the Flemish time-use surveys from 1999 and 2004 we can examine people's views on cooking in order to understand how people use time for food preparation. Although the results suggest that people consider cooking primarily as a household chore, preparing food can also be a way to please others, as well as themselves. It seems that feelings of time pressure and the family situation are clearly related to men's and women's cooking experiences. Furthermore, the meaning of cooking also tends to be clearly influenced by the meal situation and (the moment of) the day.     

Hepatic macrophages in liver homeostasis and diseases-diversity,plasticity and therapeutic opportunities

Macrophages, which are key cellular components of the liver, have emerged as essential players in the maintenance of hepatic homeostasis and in injury and repair processes in acute and chronic liver diseases. Upon liver injury, resident Kupffer cells (KCs) sense disturbances in homeostasis, interact with hepatic cell populations and release chemokines to recruit circulating leukocytes, including monocytes, which subsequently differentiate into monocyte-derived macrophages (MoMϕs) in the liver. Both KCs and MoMϕs contribute to both the progression and resolution of tissue inflammation and injury in various liver diseases. The diversity of hepatic macrophage subsets and their plasticity explain their different functional responses in distinct liver diseases. In this review, we highlight novel findings regarding the origins and functions of hepatic macrophages and discuss the potential of targeting macrophages as a therapeutic strategy for liver disease.     

A (short) history of image-guided radiotherapy.

Progress in radiotherapy is guided by the need to realize improved dose distributions, i.e. the ability to reduce the treatment volume toward the target volume and still ensuring coverage of that target volume in all dimensions. Poor ability to control the tumour's location limits the accuracy with which radiation can be delivered to tumour-bearing tissue. Image-guided radiation therapy (IGRT) aims at in-room imaging guiding the radiation delivery based on instant knowledge of the target location and changes in tumour volume during treatment. Advancements are usually not to be attributed to a single event, but rather a combination of many small improvements that together enable a superior result. Image-guidance is an important link in the treatment chain and as such a major factor in this synergetic process. A historic review shows that many of the so-called new developments are not so new at all, but did not make it into mainstream radiotherapy practice at that time. Recent developments in improved IT infrastructures, novel irradiation techniques, and better knowledge of functional and morphologic information may have created the need and optimal environment to revive the interest in IGRT.     

Subcutaneous fat necrosis of the breast

Our objective was to report the mammographic and sonographic appearance of four patients with superficial subcutaneous fat necrosis of the breast. This type of fat necrosis of the breast is poorly known. We retrospectively reviewed all of the clinical and pathological information, as well as the radiological studies, on four cases of subcutaneous fat necrosis of the breast. Mammograms and sonograms were available for review in all cases. Diagnosis was made by excisional biopsy in three patients and fine-needle aspiration in the other. The lesions were apparent clinically as a palpable mass, and were not seen at mammography. At high-frequency US each lesion was identified as an ill-defined area of increased echogenicity of the subcutaneous fat. The authors believe the sonographic appearance to be suggestive of subcutaneous fat necrosis of the breast. Correspondence to: E.A.J. Kersschot     

Physostigmine results in an increased decrement in brain glucose consumption in Alzheimer’s disease

The responsibility of cerebral cholinergic lesions for the weak clinical response to cholinergic neurotransmission enhancement of Alzheimer’s disease (AD) was studied by measuring the effects of physostigmine on glucose consumption and neuropsychological tests. Ten AD and ten aged normals (AN) were examined twice, under placebo and under maximal tolerated dose of physostigmine, in randomized order and blind fashion. Under physostigmine, both groups showed better performances in tests measuring attention (P < 0.05–0.001) but not long-term memory, and cerebral glucose consumption was regionally modified (P < 0.0001). We observed a regional decrease in AD and in AN which was larger in AD, where each patient exhibited a mean metabolic decrease. With normalized values, AD and AN showed a similar decrease in the metabolic values of prefrontal cortex and striatum (P = 0.0003). These findings suggest that cholinergic neurotransmission enhancement depresses glucose consumption and increases selective attention in similar ways in both groups, but to a larger extent in AD. This suggests that brain metabolism in AD over-responds to enhancement of cholinergic neurotransmission. The observed weak response of clinical symptomatology to anticholinesterase agents does not appear to be due to the failure to enhance the activity of the cholinergic system in AD. Received: 4 June 1997/Final version: 3 September 1997     

Cardiorespiratory responses during arm ergometry,functional electrical stimulation cycling,and two hybrid exercise conditions in spinal cord injured

Purpose.?The purpose of this study was to compare peak functional aerobic power (VO₂ peak) across four different types of exercise: arm crank ergometry (ACE), functional electrical stimulation (FES) cycling, and two hybrid exercise conditions: FES cycling combined with ACE and FES rowing using a newly developed rowing device (ROWSTIM).

Methods.?Five participants (C7 – T12), four male paraplegics with neurologically complete spinal cord injury (SCI), and one male with neurologically incomplete SCI, underwent a progressive maximal peak oxygen exercise test to ascertain peak physical work capacity during arm cranking, FES cycling, FES cycling combined with arm cranking and FES rowing.

Results.?Metabolic variables were significantly lower for FES cycling versus ACE, FES cycling combined with ACE and FES rowing measures (P < 0.05). However there were no significant differences between ACE, FES cycling combined with ACE and FES rowing.

Conclusions.?Preliminary results suggest that the ROWSTIM is as effective an exercise device or training tool for persons with SCI as ACE or combined FES-cycling and ACE, and more effective than FES-cycling. A larger sample size and further technological developments of the ROWSTIM are needed to demonstrate the efficacy of rowing over other hybrid exercise modalities and ACE.     

Extracellular matrix protein 1 (ECM1) is over-expressed in malignant epithelial tumors

The extracellular matrix protein 1 (ECM1) is a secreted protein that has been implicated with cell proliferation, angiogenesis and differentiation. In the present study, we used immunohistochemical staining to examine the expression of ECM1 in a panel of human tumors and found that it was closely correlated with some types of tumors including: invasive breast ductal carcinoma (83%), esophageal squamous carcinoma (73%), gastric cancer (88%) and colorectal cancer (78%). Significantly, ECM1expression was correlated with the metastatic properties of the tumors. Primary breast cancers that had formed metastases were 76% positive while those that had not metastasized were only 33% positive. ECM1 expression was also correlated with PCNA a marker for proliferation, but not with CD34, a marker for endothelial cells. These results indicate that ECM1 tends to be preferentially expressed by metastatic epithelial tumors.