A prospective longitudinal study of children's theory of mind and adolescent involvement in bullying

Background: Theory of mind (ToM) allows the understanding and prediction of other people’s behaviours based on their mental states (e.g. beliefs). It is important for healthy social relationships and thus may contribute towards children’s involvement in bullying. The present study investigated whether children involved in bullying during early adolescence had poor ToM in childhood. Method: Participants were members of the Environmental Risk (E‐Risk) Longitudinal Twin Study, a nationally representative sample of 2,232 children and their families. We visited families when children were 5, 7, 10 and 12 years. ToM was assessed when the children were 5 years using eight standardized tasks. Identification of those children who were involved in bullying as victims, bullies and bully‐victims using mothers’, teachers’ and children’s reports was carried out when they were 12 years’ old. Results: Poor ToM predicted becoming a victim (effect size, d = 0.26), bully (d = 0.25) or bully‐victim (d = 0.44) in early adolescence. These associations remained for victims and bully‐victims when child‐specific (e.g. IQ) and family factors (e.g. child maltreatment) were controlled for. Emotional and behavioural problems during middle childhood did not modify the association between poor ToM and adolescent bullying experiences. Conclusion: Identifying and supporting children with poor ToM early in life could help reduce their vulnerability for involvement in bullying and thus limit its adverse effects on mental health.     

Replicating the Hospital Elder Life Program in a community hospital and demonstrating effectiveness using quality improvement methodology

OBJECTIVES: To evaluate a replication of the Hospital Elder Life Program (HELP), a quality-improvement model, in a community hospital without a research infrastructure, using administrative data. DESIGN: A pretest/posttest quality-improvement study. SETTING: A 500-bed community teaching hospital in western Pennsylvania. PARTICIPANTS: Four thousand seven hundred sixty-three hospitalized patients aged 70 and older admitted to one nursing unit over 3.5 years. INTERVENTION: Application of the HELP multicomponent intervention targeting patients at risk for delirium. MEASUREMENTS: A proxy measure for delirium was developed using administrative data to calculate delirium rate and differences in variable costs of care and length of stay for patients before and after the intervention. Similar calculations were used in delirious patients for variable costs and length of stay before and after the intervention. Satisfaction surveys were administered to nursing staff and patient families before and after the intervention. RESULTS: The intervention reduced the absolute rate of delirium according to proxy report 14.4% from baseline, which represented a relative reduction in risk of 35.3% (P=.002). Total costs on this 40-bed nursing unit were reduced $626,261 over 6 months. Satisfaction of nursing staff and families was high in the intervention group. In addition, the intervention showed sustained benefits over time and remains funded by the hospital. CONCLUSION: HELP can be successfully replicated in a community hospital, yielding clinical and financial benefits.     

Effectiveness of Wellness Recovery Action Planning (WRAP) for Chinese in Hong Kong

The present study evaluated the effectiveness of the Wellness Recovery Action Planning (WRAP) in a matched controlled design among individuals in recovery of mental illness in Hong Kong. Feedback from the first batch of WRAP facilitators in Hong Kong was sought for future implementation of WRAP. Participants were recruited from the service units of the largest nongovernmental organization (NGO) serving people in recovery in Hong Kong. Fifty-nine service users were recruited to learn WRAP and 59 service users served as matched controls. The WRAP program consisted of eight weekly sessions delivered by NGO staff who were certified WRAP facilitators. Assessments were completed before, immediately after, and 3 months after the program. Findings based on repeated measures ANOVAs showed that compared with their matched controls, WRAP participants reported significant increase in perceived social support. No significant change was noted in empowerment, hope, self-stigma, social network size, symptom severity, and recovery. Facilitators discussed issues on cultural adaptation and resources needed for future implementation of WRAP for Chinese. Discrepancies between the present findings and those from previous studies were discussed. This is the first quantitative study evaluating the effectiveness of WRAP among Chinese.     

Measurement of peripheral blood mononuclear cells producing IFN-Gamma in patients with tuberculosis

The type of immune response induced by tuberculosis (Th1 or Th2) and its correlation with the clinical outcome is unclear. We studied 13 patients with active tuberculosis (TBC). The peripheral blood mononuclear cells producing IFN-gamma (PBMC-IG) were measured by enzyme-linked immunospot (ELISPOT) technique. The control group had ten healthy individuals vaccinated against tuberculosis. We collected blood samples of each patient in two moments: a) in the hospital admission without treatment (TBC1); b) after seven to 20 days of treatment (TBC2). The comparison of the spots forming units of PBMC-IG between TBC group and controls showed that there was a significant difference between TBC1 and control group (p < 0.001) and between TBC2 and control group (p < 0.005), but there was no difference between TBC1 and TBC2 (p > 0.05). A positive correlation was found between PBMC-IG and hemoglobin value, as well as between PBMC-IG and weight loss. There was no correlation between PBMC-IG and other variables [age, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)]. We conclude that tuberculosis activates Th1 immune response due to increase of PBMC producing IFN-gamma. There was no difference between the first sample (TBC1) and the second sample (TBC2) of PBMC-IG. This result can have occurred due to treatment influence, or can indicate that the immune response reachs a plateau. The positive correlation among PBMC-IG and both hemoglobin level and weight loss indicates that may exist a link between patient's clinical status and the immune response intensity.     

The prenatal ultrasonographic detection of myelomeningocele in patients referred to Children's Hospital Medical Center: a cross sectional study

Background  

To find out about the prenatal diagnosis rate of myelomeningocele (MMC) by ultrasound scan in patients referred to the Children's Hospital Medical Center in Tehran, Iran from July 2004 to July 2005.     

Sole abnormalities of chromosome 7 in myeloid malignancies: spectrum, histopathologic correlates, and prognostic implications

Among 6,565 consecutive abnormal cytogenetic reports at our institution, 3,192 (49%) constituted sole abnormalities, of which 230 (7%) involved chromosome 7: monosomy 7 (n = 98), 7q- (n = 51), der(1;7)(q10;p10) (n = 44), balanced translocations (n = 15), ring 7 (n = 13), and 7p- (n = 9). The most frequent histopathologic correlates were myelodysplastic syndromes (MDS; 28%), acute myeloid leukemia (AML; 17%), secondary or therapy-related MDS/AML (13%), primary myelofibrosis (PMF; 7%), and chronic myelomonocytic leukemia (6%). Monosomy 7 was the most frequent in each one of these disease categories except PMF where 7q- was more frequent. In primary MDS, patients with der(1;7)(q10;p10) (n = 13), compared to those with monosomy 7 (n = 30) or 7q- (n = 15), were less likely (P = 0.04) to display excess blasts or multilineage dysplasia but overall and leukemia-free survival adjusted for these variables revealed no significant difference between the three groups (P = 0.57 and 0.81, respectively). The current study does not prognostically distinguish monosomy 7 from 7q- or der(1;7), in MDS.     

Predictive factors,outcomes, and molecular epidemiology of Clostridioides difficile diarrhea in Brazilian hospitals

European Journal of Clinical Microbiology & Infectious Diseases - Little is known about the role of lineage of strains of Clostridioides difficile (CD) on the clinical presentation of CD...     

PEER REVIEWED: Process, Rationale, and Interventions of Pakistan’s National Action Plan on Chronic Diseases

Most developing countries do not comprehensively address chronic diseases as part of their health agendas because of lack of resources, limited capacity within the health system, and the threat that the institution of national-level programs will weaken local health systems and compete with other health issues. An integrated partnership-based approach, however, could obviate some of these obstacles.

In Pakistan, a tripartite public–private partnership was developed among the Ministry of Health, the nongovernmental organization (NGO) Heartfile, and World Health Organization. This was the first time an NGO participated in a national health program; NGOs typically assume a contractual role. The partnership developed a national integrated plan for health promotion and the prevention and control of noncommunicable diseases (NCDs), which as of January 2006 is in the first stage of implementation. This plan, called the National Action Plan on NCD Prevention, Control, and Health Promotion (NAP-NCD), was released on May 12, 2004, and attempts to obviate the challenges associated with addressing chronic diseases in countries with limited resources. By developing an integrated approach to chronic diseases at several levels, capitalizing on the strengths of partnerships, building on existing efforts, and focusing primary health care on chronic disease prevention, the NAP-NCD aims to mitigate the effects of national-level programs on local resources.

The impact of the NAP-NCD on population outcomes can only be assessed over time. However, this article details the plan's process, its perceived merits, and its limitations in addition to discussing challenges with its implementation, highlighting the value of such partnerships in facilitating the missions and mandates of participating agencies, and suggesting options for generalizability.