Patients' recollections of helmet-CPAP treatment during COVID-19 pandemic: A qualitative study.

BACKGROUND: During the pandemic outbreak, helmet continuous positive airway pressure (CPAP) was widely used as respiratory support for COVID-19 patients, inside and outside of intensive care units. The available literature suggests specific interventions to improve the comfort of patients treated with helmet-CPAP. Few reports are available on the experiences of patients undergoing this treatment. AIM: This qualitative study aimed to explore the views and recollections of COVID-19 patients undergoing helmet-CPAP. STUDY DESIGN: We conducted semi-structured interviews with thematic analysis. Participants were recruited from the follow-up programme for COVID-19 patients discharged from an Italian general intensive care unit. Participants were interviewed by telephone. Data analysis followed the principles of thematic synthesis approach. FINDINGS: We conducted 29 phone calls in patients eligible for the study. Five participants declared that they did not remember the time spent in hospital on helmet-CPAP. Twenty-four patients were then included. Two themes and six subthemes were generated from their interview data: (1) The helmet-CPAP as a life-saving treatment (subthemes: recognition of the usefulness of treatment and resilience); (2) the negative feelings related to helmet-CPAP application (subthemes: communication problems, entrapment, mental confusion, fear of dying). Each patient's experience was unique, but some discomfort elements such as noise, gas flow turbulence, choking sensation and thirst were found to be very common. CONCLUSIONS: The application of helmet-CPAP treatment generated positive and negative memories and feelings in COVID-19 patients during the pandemic. The patients' experience has provided an overview of the main factors of discomfort. This can be a starting point for taking corrective measures to promote greater helmet tolerance and subsequent treatment success. RELEVANCE TO CLINICAL PRACTICE: This study has provided an insight into the patient's recollections about helmet-CPAP treatment during a worldwide pandemic. The findings suggested strict applications of interventions aimed to reduce some issues that participants reported, to improve their compliance to treatment. Results from this study could help nurses in understanding the needs of patients treated with helmet-CPAP and may foster a care focused on patient-centred outcomes.

"Sitting in the back seat": The convergence of early recollections, self and others, and low socioeconomic class.

This qualitative study examines the links between early recollections, self and others, and low socioeconomic class. Early recollections-specific memories from childhood-illustrate individuals' core concepts about self and life. Social class is a cultural context that affects psychological processes. We conducted semistructured interviews with 12 low socioeconomic status participants and elicited at least 3 early recollections per participant (totaling 42 recollections). Themes that emerged from analysis of the early recollections include divided reality; creating meaning in the present (including enjoying life and making do with what one has); a parental role of admiration, security, and compensation; and social interest. We regard these strategies as creative assets and mechanisms to deal with a lack of control and resources, sense of constraint, and hierarchical and classed society. We encourage educational and therapeutic frameworks to recognize these assets as facets of psychological and cultural capital.

Can we trust Einstein's accounts of the genesis of special relativity?

There are three kinds of sources available to reconstruct the reflections that led Einstein to special relativity: a few contemporary letters and documents, his impersonal accounts of the genesis of this theory, and recollections of his own path. At first glance, contradictions within and between these sources hamper the reliability of Einstein's accounts. Yet, a closer analysis reveals much more consistency than foreseen and helps eliminate the dubious, contradictory elements. It then becomes possible to combine the three kinds of sources to produce a minimally speculative and yet fairly coherent account of the genesis of special relativity.

Adult Maltese Women's Understanding of How Childhood Domestic Violence Has Impacted Their Relationships with Their Parents and Siblings: A Grounded Theory Study.

Most of the literature that has looked at children's relationships with their parents in the domestic violence context has focused solely on the children's relationship with one parent or is studied from the perspective of one parent, usually the mother. Sibling relationships in the same context are also under-studied. This paper explores in more detail the complexity of children's relationships with their mothers, fathers, and siblings over time from the perspective of adult women and survivors of childhood domestic violence. Methods: A grounded theory methodology was used to analyse the interviews with 15 women aged twenty to forty-three years of age living in Malta. Results: the analysis showed that the domestic violence context remains significant in these important relationships for these women. The relationship with the father remains strongly influenced by the dynamics of fear, love, and retaliation, with cycles of cut-off and connection from the adult daughter's end. The relationship with the mother is complicated-feelings of love that are seen as having been limited and complicated by betrayal if there was abuse from the mother. Similarly, for the siblings, the roles of the early family of origin remain persistent and significant. However, in some of these relationships, there has been transformation, reconciliation, and forgiveness. The article offers implications for therapeutic practice for dealing with the complexity of these relationships and ideas for future research.

Vortexing specimens to disaggregate platelet clumps in EDTA specimens.

OBJECTIVE: To compare platelet count results of specimens that yield platelet clump flags to platelet count results on these specimens after vortexing. METHOD: Specimens that generated platelet count flags on Sysmex XN 3000 instruments were vortexed and rerun. Only data from specimens demonstrating elimination of platelet clump flags were used in this study. Pearson r analysis was performed on data. RESULTS: Comparison of complete blood count results (white blood cell count, red blood cell count, hemoglobin, hematocrit, and platelet count) all yielded Pearson r scores >0.9. CONCLUSION: Additional patient comfort and safety concerns, as well as concerns over additional specimen collection and processing costs, may be avoided by vortexing and rerunning specimens flagged for platelet clumps when the platelet count is normal.

Biased reporting of past self-injurious thoughts and behaviors: A literature review.

BACKGROUND: Accurate assessment of suicide risk is critical for clinical practice, empirical advances, and informing public policy. In this narrative review of the literature, we compiled evidence from longitudinal studies that identify reporting bias of past self-injurious thoughts and behaviors (SITB) and examined possible correlates of inconsistent reporting. METHOD: We conducted an extensive literature search, including 19 longitudinal samples or subsamples who reported the presence of current or past SITB at an initial but not at a subsequent assessment (yes/no inconsistent reports). RESULTS: The median was 33%, and the weighted mean was 39% (95% CI, 37%-41%) for the prevalence of inconsistent reporting of SITB across the longitudinal samples. Importantly, inconsistent reports were linked with less internalizing psychopathology and more adaptive functioning. The type of sample recruited and assessment interval may also be relevant factors to consider. LIMITATIONS: Variability of sample characteristics and methodology made it challenging to draw firm conclusions across studies but provide information about critical sources of bias. CONCLUSIONS: Results suggest considerable caution for clinical, empirical, and policy decision-making based on lifetime reports of suicide and encourage a continued consideration for identifying potential reporting biases for SITB.

Does Examining the Childhood Food Experiences Help to Better Understand Food Choices in Adulthood?

Impact of parental feeding practices on children's eating behaviors is well-documented in the literature. Nevertheless, little is known about how many of these behaviors might persist into adulthood. There is a lack of a tool measuring childhood feeding experiences recollected by adults, while the Comprehensive Feeding Practices Questionnaire (CFPQ) is used to measure parental feeding practices applied towards children. The aim of the study was to adapt the CFPQ to measure adults' recollections of their childhood (5-10 years old) feeding experiences, to examine its discriminant validity and then to assess if these practices are related to adults' food choices. In 2020, the modified version of CFPQ (mCFPQ) and questions on current food consumption were administered in a group of 500 adults twice over a two-week interval. The analysis included 443 participants whose questionnaires were correctly completed in both stages of the study. The Q-sorting procedure was used to test for discriminant validity of the questionnaire, i.e., confirmatory and exploratory factor analysis (EFA), Cronbach's alpha, correlations coefficients, and the analysis of the differences between groups according to the intake of certain food products. Test-retest reliability was examined by calculating interclass correlation coefficients (ICC) for each obtained factor. As a result of EFA, five subscales were identified: "Restrictions", "Healthy Eating Guidance", "Pressure and Food Reward", "Monitoring", and "Child Control". Items from these subscales created a new tool-Adults' Memories of Feeding in Childhood (AMoFiC). Test for internal consistency, factor correlations, and discriminant validity proved satisfactory psychometric parameters of AMoFiC. "Pressure and Food Reward" and "Child Control" were associated with higher intake of sweets and salty snacks, whereas "Healthy Eating Guidance", "Monitoring", and "Restrictions" were associated with higher consumption of fresh fruits and vegetables. Despite the fact that the AMoFiC questionnaire requires further research, the findings of the study might be of practical use in counseling addressed to the parents.

Patients' memories from intensive care unit: A qualitative systematic review.

AIM: To identify and synthesize the evidence regarding adult patients' memories from their stay in the intensive care unit. DESIGN: A qualitative systematic review and meta-synthesis. PROSPERO # CRD42020164928. The review employed the guideline of Bettany-Saltikov and McSherry and the Enhancing transparency in reporting the synthesis of qualitative research guidelines. METHODS: Systematic search for qualitative studies published between January 2000 and December 2019 in Cumulative Index to Nursing and Allied Health, Medical Literature Analysis and Retrieval System Online, PsycINFO, and Excerpta Medica Database. Pairs of authors independently assessed eligibility, appraised methodological quality using Joanna Briggs's quality appraisal tool and extracted data. The analysis followed the principles of interpretative synthesis. RESULTS: Sixteen papers from 15 studies were included in the review. Three themes emerged: (a) memories of surreal dreams and delusions, (b) care memories from sanctuary to alienation and (c) memories of being vulnerable and close to death.

The importance of cancer patients' functional recollections to explore the acceptability of an isometric-resistance exercise intervention: A qualitative study.

BACKGROUND AND AIMS: Although it has been widely recognized the potential of physical activity to help cancer patients' preparation for and recovery from surgery, there is little consideration of patient reflections and recovery experiences to help shape adherence to exercise programs. The aim was to explore the acceptability of our newly proposed isometric exercise program in a large general hospital trust in England providing specialist cancer care by using patient recollections of illness and therapy prior to undertaking a randomized controlled trial. METHODS: Four Focus groups (FGs) were conducted with cancer survivors with an explicit focus on patient identity, functional capacity, physical strength, exercise advice, types of activities as well as the timing of our exercise program and its suitability. Thematic framework analysis was used with NVivo 11. RESULTS: FG data was collected in January 2016. A total of 13 patients were participated, 10 were male and 3 were female with participants' ages ranging from 39 to 77. Data saturation was achieved when no new information had been generated reaching "information redundancy." Participants reflected upon their post-surgery recovery experiences on the appropriateness and suitability of the proposed intervention, what they thought about its delivery and format, and with hindsight what the psychological enablers and barriers would be to participation. CONCLUSION: Based upon the subjective recollections and recovery experiences of cancer survivors, isometric-resistance exercise interventions tailored to individuals with abdominal cancer has the potential to be acceptable for perioperative patients to help increase their physical activity and can also help with emotional and psychological recovery.

Recalling a Devastating Tornado: Qualities of Child Recollections and Associations with Mental Health Symptoms.

Trauma recollections often contain trauma-related cognitive and emotional processing. Research examining indicators of such processing in children's trauma recollections and their association with mental health symptoms is limited. Fifty 8 to 12-year-old children provided two open-ended recollections about (1) challenging/"bad" things and (2) positive/ "good" things that happened to them 1-year post experiencing an EF-5 tornado. Children completed exposure and mental health symptom measures (PTSD, anxiety, depression). Transcripts were coded for indicators of processing: coherence, positive and negative emotion terms, and resolutions. Age, gender, SES, family tornado-related discussion frequency, verbal ability, tornado-specific psychotherapy receipt, and exposure were controlled. Coherence and positive emotion were positively associated and resolutions were negatively associated with mental health symptoms when children discussed the "bad" things. Children's processing and mental health symptoms were unrelated when children discussed the "good" things. The measured indicators of children's processing may reflect children's meaning-making efforts and have implications for adjustment.

Changes in cerebellar functional connectivity and autonomic regulation in cancer patients treated with the Neuro Emotional Technique for traumatic stress symptoms.

PURPOSE: A growing number of research studies have implicated the cerebellum in emotional processing and regulation, especially with regard to negative emotional memories. However, there currently are no studies showing functional changes in the cerebellum as a result of treatment for traumatic stress symptoms. The Neuro Emotional Technique (NET) is an intervention designed to help improve symptoms related to traumatic stress using an integrative approach that combines emotional, cognitive, and motor processing, with a particular focus on autonomic nervous system regulation. In this study, we evaluated whether the NET intervention alters functional connectivity in the brain of patients with traumatic stress symptoms associated with a cancer-related event. We hypothesized that the NET intervention would reduce emotional and autonomic reactivity and that this would correlate with connectivity changes between the cerebellum and limbic structures as well as the brain stem. METHODS: We enrolled patients with a prior cancer diagnosis who experienced distressing cancer-related memories associated with traumatic stress symptoms of at least 6 months in duration. Participants were randomized to either the NET intervention or a waitlist control. To evaluate the primary outcome of neurophysiological effects, all participants received resting-state functional blood oxygen level-dependent (BOLD) magnetic resonance imaging (rs-fMRI) before and after the NET intervention. In addition, autonomic reactivity was measured using heart rate response to the traumatic stimulus. Pre/post comparisons were performed between the NET and control groups. RESULTS: The results demonstrated significant changes in the NET group, as compared to the control group, in the functional connectivity between the cerebellum (including the vermis) and the amygdala, parahippocampus, and brain stem. Likewise, participants receiving the NET intervention had significant reductions in autonomic reactivity based on heart rate response to the traumatic stimulus compared to the control group. CONCLUSIONS: This study is an initial step towards establishing a neurological signature of treatment effect for the NET intervention. Specifically, functional connectivity between the cerebellum and the amygdala and prefrontal cortex appear to be associated with a reduction in autonomic reactivity in response to distressing cancer-related memories. IMPLICATIONS FOR CANCER SURVIVORS: This study contributes to the understanding of possible mechanisms by which interventions like NET may help reduce emotional distress in cancer patients who suffer from traumatic stress symptoms.

Neuro emotional technique effects on brain physiology in cancer patients with traumatic stress symptoms: preliminary findings.

PURPOSE: The purpose of this study was to characterize the neurophysiological and clinical effects that may result from the neuro emotional technique (NET) in patients with traumatic stress symptoms associated with a cancer-related event. We hypothesized that self-regulatory processing of traumatic memories would be observable as physiological changes in key brain areas after undergoing the NET intervention and that these changes would be associated with improvement of traumatic stress symptoms. METHODS: We enrolled 23 participants with a prior cancer diagnosis who expressed a distressing cancer-related memory that was associated with traumatic stress symptoms of at least 6 months in duration. Participants were randomized to either the NET intervention or a waitlist control condition. To evaluate the primary outcome of neurophysiological effects, all participants received functional magnetic resonance imaging (fMRI) during the auditory presentation of both a neutral stimulus and a description of the specific traumatic event. Pre/post-comparisons were performed between the traumatic and neutral condition, within and between groups. Psychological measures included the Impact of Event Scale (IES), State Trait Anxiety Index (STAI), Brief Symptom Inventory (BSI)-18, and Posttraumatic Cognitions Inventory (PTCI). RESULTS: The initial fMRI scans in both groups showed significant increases in the bilateral parahippocampus and brainstem. After NET, reactivity in the parahippocampus, brainstem, anterior cingulate, and insula was significantly decreased during the traumatic stimulus. Likewise, participants receiving the NET intervention had significant reductions (p < 0.05) compared to the control group in distress as measured by the BSI-18 global severity index, anxiety as measured by the STAI, and traumatic stress as measured by the IES and PTCI. CONCLUSIONS: This study is an initial step towards understanding mechanistic features of the NET intervention. Specifically, brain regions involved with traumatic memories and distress such as the brainstem, insula, anterior cingulate gyrus, and parahippocampus had significantly reduced activity after the NET intervention and were associated with clinical improvement of symptoms associated with distressing recollections. IMPLICATIONS FOR CANCER SURVIVORS: This preliminary study suggests that the NET intervention may be effective at reducing emotional distress in patients who suffer from traumatic stress symptoms associated with a cancer-related event.