Experiences of family caregivers of patients with bipolar disorder

Introduction: Attention to caregiving consequences has been mainly restricted to bipolar disorder, although studies suggest that relatives of bipolar patients also experience considerable distress. The purpose of this study was to explore the lived experiences of family member caregivers of bipolar disorder patients. Methods: In a qualitative research of phenomenological methodology, family member caregivers of bipolar disorder patients in Farshchian Psychiatric Hospital in Hamedan (Iran) were selected by purposive sampling in the year 2010. By reaching data saturation, the number of participants was 12. Data were gathered through in‐depth interviews and analyzed by van Manen method. Results: Analysis of the interviews revealed six major themes: fears and anxiety for the future, psychosomatic impact, feeling isolated and loneliness, financial impact, change in lifestyle and family functioning, and lack of support and knowledge. Discussion: This study highlights the need for family‐oriented mental health services to be developed and for further research to identify the specific nursing interventions that are effective in helping to sustain family caregiving.     

Memory suppression in Alzheimer’s disease

An important challenge for memory is the competition between appropriate and inappropriate information during retrieval. This competition is normally reduced thanks to controlled inhibitory processes that suppress irrelevant memories. In Alzheimer’s disease (AD), compromise of suppression ability may result in strong competition between relevant and irrelevant memories during retrieval. The present review highlights this issue by examining studies using the directed forgetting method in AD. This method in which participants are typically instructed to forget no longer relevant information is argued to reflect suppression in memory. Studies using the directed forgetting method suggest that AD participants experience difficulties when they are asked to suppress no longer relevant information in working, autobiographical, source and destination memory. Difficulties in suppressing irrelevant information, as may be observed in AD, may hamper memory retrieval by activating irrelevant memories at the expense of relevant ones.     

Trusted Autonomy and Cognitive Cyber Symbiosis: Open Challenges

This paper considers two emerging interdisciplinary, but related topics that are likely to create tipping points in advancing the engineering and science areas. Trusted Autonomy (TA) is a field of research that focuses on understanding and designing the interaction space between two entities each of which exhibits a level of autonomy. These entities can be humans, machines, or a mix of the two. Cognitive Cyber Symbiosis (CoCyS) is a cloud that uses humans and machines for decision-making. In CoCyS, human–machine teams are viewed as a network with each node comprising humans (as computational machines) or computers. CoCyS focuses on the architecture and interface of a Trusted Autonomous System. This paper examines these two concepts and seeks to remove ambiguity by introducing formal definitions for these concepts. It then discusses open challenges for TA and CoCyS, that is, whether a team made of humans and machines can work in fluid, seamless harmony.     

Posttraumatic Stress Disorder in individuals with diagnosis of Autistic Spectrum Disorders

Although children and adolescents with developmental disabilities are said to have higher risks of abuse than those without, trauma and Posttraumatic Stress Disorder (PTSD) are little examined in those diagnosed with Autistic Spectrum Disorders (ASDs). Our study aims to assess trauma types, prevalence, risk factors and symptoms; and PTSD in individuals with diagnosis of ASD. Participants were 69 children and adolescents (53 males, 16 females) who were consecutively followed-up at our clinic and met DSM-IV criteria for ASD. Assessment was done using semi-structured interview forms. 18 had trauma history and 12 were diagnosed with PTSD. Witnessing or being a victim of accidents/disasters/violence was the most common type of trauma. Interestingly, the rate of sexual and/or physical abuse was less than in the general population. Trauma history and PTSD rates were higher in girls than boys. Deterioration in social and communicative abilities, increase in stereotypes, aggression, distractibility, sleep disorders, agitation, hyperactivity, self-injury, and loss of self-care skills were the most common symptoms detected following trauma. These results underscore the importance of detailed assessment of behavioral and emotional problems in this group by ruling out any trauma history at periods which might otherwise be misdiagnosed as an exacerbation of symptoms of ASD.     

Preoperative vs. Postoperative Bilateral Paravertebral Blocks for Laparoscopic Cholecystectomy: A Prospective Randomized Clinical Trial

Background: The aim of this clinical trial was to determine the potential analgesic effect of preoperative paravertebral blockade in patients undergoing laparoscopic cholecystectomy. Methods: Sixty patients scheduled for laparoscopic cholecystectomy were randomized to one of two groups with 30 patients each: bilateral nerve stimulator guided paravertebral blockade at the T5 to T6 level either prior to induction of general anesthesia (Group 1) or blockade immediately postoperatively (Group 2). Results: The preoperative paravertebral block group had significantly lower visual analog scale scores compared with the postoperative paravertebral block group both at rest 12 hours postoperatively (1.06 vs. 1.89; P < 0.05), on movement 12 hours postoperatively (1.89 vs. 3.00; P < 0.001) and on coughing 12 hours postoperatively (2.24 vs. 3.17; P < 0.01). The consumption of analgesics as well as the duration of hospital stay was significantly reduced in patients receiving preoperative paravertebral blocks (P < 0.05). [Correction added after online publication 27th May 2011: visual analog scores were amended] Conclusion: Bilateral paravertebral blockade performed prior to general anesthesia for laparoscopic cholecystectomy can provide early discharge and better postoperative pain management.     

Topical effectiveness of kiwifruit versus fibrinolysin ointment on removal of necrotic tissue of full‐thickness burns in male rats

Formation of necrotic tissues is a major issue affecting treatment of full‐thickness burns. This study was designed to compare topical effectiveness of applying kiwifruit versus fibrinolysin on removal of necrotic tissue of burns. Ten adult male Wistar rats were randomly assigned to three groups. For group 1, the right‐side wounds were treated with kiwifruit and the other side with fibrinolysin. For group 2, the wounds on the right side were treated with kiwifruit or fibrinolysin, and the left sides were kept as control group 2. All wounds in group 3 were considered as control group 1. The control wounds were left to heal naturally. In each group and for each wound, the time of debridement were noted. The results indicated that for the wounds where kiwifruit was applied, the average time for removal of dead tissue was 5.7 days, which is significantly shorter than the average 18.5 days it took for treatment with fibrinolysin (p = 0.02). However, there were no significant differences between control wounds 1 and 2. Findings of the present study can open new horizons and provide a new treatment modality for patients with deep burns.