Systematic review (meta-aggregation) of qualitative studies on the experiences of family members caring for individuals with early psychosis.

Despite the importance of the role of caregivers of people with psychosis being widely recognized, comprehensive understanding of their experience is limited. A thorough understanding of the experience of caregivers over the journey of the illness, particularly during its early stages, is crucial. Qualitative studies published between 1 January 1949 and 31 January 2018 were obtained from seven databases based on PICo search strategy. Meta-aggregation methodology of the Joanna Briggs Institute (JBI) was adopted to aggregate existing qualitative findings about caregivers' experiences. Twenty-eight qualitative studies on 635 caregivers and family members were included in the review. Six inter-related categories-'stigma', 'help-seeking', 'service encounter', 'emotional challenges', 'on becoming a caregiver' and 'making sense of experience'-were aggregated from 129 themes from the sub-acute stage, the acute stage and the recovery or residual stage. Three statements about caregivers' experiences of their relative's first episode of psychosis were synthesized from the findings. Results highlighted the need of incorporating caregiver intervention into the existing services to support the emotional challenges, uncertainty, and stigma-related burden along the caregiving journey.

Intimate partner violence victims' acceptance and refusal of on-site counseling in emergency departments: Predictors of help-seeking behavior explored through a 5-year medical chart review.

Healthcare services constitute the first formal support that many intimate partner violence (IPV) victims receive and a link to formal welfare and psychological support. The help-seeking behavior for psychosocial support, e.g., Accident and Emergency Departments (AED) onsite counseling, is key to developing effective support for IPV victims. This study aimed to strengthen the health-welfare support link to aid IPV prevention in AEDs by investigating the acceptance and refusal of on-site counseling by IPV victims. A retrospective cohort study retrieved and reviewed all records of IPV victims presenting at the AEDs of two Hong Kong hospitals between 2010 and 2014. A total of 157 male and 823 female IPV victims were identified, 295 of whom refused on-site counseling. Bivariate and multivariate analyses were performed to examine the association between help-seeking and demographic and violent injury-related factors. The odds of help-seeking via on-site counseling were significantly lower for victims with mental illness (aOR=0.49; 95% CI=0.27, 0.88). After controlling for all demographic characteristics, mental illness, and drug abuse information, sex remained an independent predictor of help-seeking (aOR=2.62; 95% CI=1.45, 4.74); victims who had experienced >2 abuse incidents were more likely to seek help than those who had experienced ≤2 abuse incidents (aOR=1.90; 95% CI=1.11, 3.26). The factors associated with help-seeking from on-site services by IPV victims reflect the need for multidisciplinary collaborative work aimed at IPV prevention. Healthcare professionals require training on how to promote help-seeking behavior targeted specifically for male and female IPV victims according to their needs and preferences.

Online social work engagement and empowerment for young internet users: A quasi-experiment.

BACKGROUND: The increasing penetration of Internet use among young people poses challenges for youth service engagement through bricks-and-mortar youth centers owing to the decline in the number of walk-ins. This study was to identify the psychosocial and behavioral outcome changes effected through online engagement and empowerment interventions offered to at-risk youths by three local social work youth service providers. METHODS: A quasi-experimental design was adopted to compare the effects of online engagement and empowerment on 182 young service users with 191 age- and gender-matched controlled participants over nine months. RESULTS: Significant improvement in emotional distress and social withdrawal behaviors were found in the intervention group. LIMITATIONS: Non-randomized study, nonequivalent comparison group DISCUSSION: Whether online social work services can substitute offline services should be further examined in randomized controlled trials. Online social work intervention identifies its acceptability among young people and professional feedback holds promise for providing a complimentary route of alleviating emotional distress and social withdrawal in at-risk youths.

The role of symptoms and insight in mediating cognition and functioning in first episode psychosis.

INTRODUCTION: Achieving functional recovery in patients with psychosis is a challenge in clinical practice. Investigating the complex interplay between cognition, symptoms, insight and functional outcome in first episode psychosis will be crucial to understanding the factors leading to better functioning. METHODS: In this 12-month prospective follow-up study, we investigated how cognition, clinical symptoms, and insight into illness affected overall functioning in 160 patients with first episode psychosis recruited from the Early Assessment Service for Young People with Psychosis (EASY) in Hong Kong from July 1, 2014 to June 30, 2016. Cognition was assessed at baseline while symptoms, insight, and functioning were assessed at 12-month follow-up. Structural equation modelling was used to examine the direct and indirect relationships between functioning and other latent constructs. RESULTS: Symptoms (negative symptoms and general psychopathology) and insight were shown to be significant mediators between cognition and functioning. The significant direct relationship between cognition and functioning (ß = 0.387; p < 0.001) became insignificant (ß = 0.079; p = 0.578) after including symptoms and insight in the model. Symptoms and insight were significantly associated with cognition (symptoms, ß = -0.469; p < 0.001; insight, ß = -0.372; p < 0.001) and predicted functioning (symptoms, ß = -0.558; p < 0.001; insight, ß = -0.264; p < 0.01). CONCLUSION: Symptoms and insight mediated the effects of cognition on functioning. Interventions for improving functioning in patients with first episode psychosis should target not only cognition but also symptoms and insight.

Time-resolved resonance Raman investigation of the 2-fluorenylnitrenium ion reactions with C8 guanosine derivatives.

A nanosecond time-resolved resonance Raman (ns-TR3) spectroscopic study of the reactions of the 2-fluorenylnitrenium ion with several C8-substituted guanosine derivatives is reported. The TR3 spectra show that the 2-fluorenylnitrenium ion reacts with the C8-substituted guanosine derivatives (C8-methylguanosine and C8-bromoguanosine) to produce C8 intermediates with the methyl and bromine moieties still attached to the intermediate species at the C8 position. The C8-bromoguanosine species was observed to be less reactive toward the 2-fluorenylnitrenium ion compared to the guanosine and C8-methylguanosine species. Comparison of the TR3 spectra to the results obtained from density functional theory calculations was used to characterize the C8 intermediates observed to learn more about their structure and properties. The implications of these results for the chemical reactivity of arylnitrenium ions toward substituted guanosine derivatives are briefly discussed.

Time-resolved resonance Raman study of the reaction of the 2-fluorenylnitrenium ion with 2-fluorenylazide.

A time-resolved resonance Raman investigation of the reaction of the 2-fluorenylnitrenium ion with 2-fluorenylazide in a mixed aqueous solvent is presented. The reaction of the 2-fluorenylnitrenium ion with 2-fluorenylazide in the mixed aqueous solution generates two new species on the microsecond time scale. One of these species is identified as 2,2'-azobisfluorene, and the other species is tentatively assigned to a 1,4-bis-(2,2'-fluorenyl)-tetrazadiene cation intermediate. The structure and properties of these two species are briefly discussed. The reaction of the 2-fluorenylnitrenium ion with 2-fluorenylazide is also briefly compared to that of the 2-fluorenylnitrenium ion reactions with guanosine and water.

Direct observation of the 4-methoxyphenylnitrene intersystem crossing from S1 to T1 using picosecond Kerr-gated time-resolved resonance Raman spectroscopy.

A picosecond Kerr-gated time-resolved resonance Raman (ps-KTR(3)) study of the singlet 4-methoxyphenylnitrene intersystem crossing to produce the triplet 4-methoxyphenylnitrene species is reported. The experimental resonance Raman vibrational band frequencies observed for the singlet and triplet 4-methoxylphenylnitrene species in the time-resolved Raman experiments are compared to each other and to predictions from previously published density functional theory calculations. The structure, properties, and chemical reactivity of the singlet and triplet states of the 4-methoxyphenylnitrenes are briefly discussed.

Time-resolved resonance Raman observation of the 2-fluorenylnitrenium ion reaction with guanosine to form a C8 intermediate.

Time-resolved resonance Raman spectroscopy was used to directly observe the reaction of the 2-fluorenylnitrenium ion with guanosine to produce a C8 intermediate species. Comparison of the Raman spectra with results of density functional theory calculations indicates the C8 intermediate forms two C=N conjugated bonds in ring 1 of the guanosine moiety.

Transient resonance Raman and density functional theory investigation of the 4-acetamidophenylnitrenium ion.

This paper reports a transient resonance Raman and density functional theory study of the 4-acetamidophenylnitrenium ion in a mostly aqueous solvent. The transient Raman bands combined with results from density functional theory calculations indicate that the spectrum should be assigned to the singlet state of the 4-acetamidophenylnitrenium ion. The 4-acetamidophenylnitrenium ion was found to have a substantial iminocyclohexadienyl character comparable to previously studied para-phenyl-substituted phenylnitrenium ions and noticeable charge on both the acetamido and nitrenium moieties. The structure and properties of the 4-acetamidophenylnitrenium ion are compared to those of other arylnitrenium ions. We briefly discuss the chemical reactivity and selectivity of the para-acetamido-substituted phenylnitrenium ions compared to para-phenyl- or para-alkoxy-substituted phenylnitrenium ions.