Prevalence of respiratory signs in dogs with chronic gastroenteropathy in a referral population in the United Kingdom: 42 cases (2020).

OBJECTIVES: To determine the prevalence of respiratory signs in a referral population of dogs with chronic gastroenteropathy in the United Kingdom, and to describe the epidemiology and clinical presentation of the affected dogs. MATERIALS AND METHODS: Retrospective review of canine patients diagnosed with chronic gastroenteropathy in a referral centre in the United Kingdom. Data included signalment, gastrointestinal and respiratory signs, blood analysis results and, where present, diagnostic imaging techniques, endoscopy, videofluoroscopic swallow study, bronchoalveolar lavage results and treatment response. To be included, a follow-up of a minimum of 3 months was required. Cases were excluded if there was no minimum diagnostic dataset, the aetiology of the respiratory signs was other than gastrointestinal disease or a non-gastrointestinal systemic disease was the cause of the gastrointestinal signs. RESULTS: One hundred and forty-eight dogs were included and 42 (28.4%) had concurrent respiratory signs. Gagging (69%) and vomiting (52.4%) were the most common gastrointestinal signs, while coughing (50%), tachypnoea (33.3%) and reverse sneezing (30.9%) were the most common respiratory signs. Abdominal ultrasound was performed in 31 (73.8%) while CT scan was the most common modality for thoracic (62.5%) and head (21.9%) imaging. Endoscopic procedures included gastrointestinal (54.8%), bronchoscopy (19%) and rhinoscopy (23.8%). Dietary modification was the most common treatment (66.67%). Eleven dogs (26.2%) had a relapse of the respiratory signs during the follow-up period, of which, nine (81.8%) had a concurrent relapse of the gastrointestinal signs. CLINICAL SIGNIFICANCE: Concurrent respiratory signs in dogs with chronic gastroenteropathy are frequent. A clinical improvement of these respiratory signs might be achieved during the therapeutic management of gastrointestinal disorders.

Mental health professionals' attitudes towards consumer participation in inpatient units.

Consumer participation has been a major focus in mental health services in recent years, but the attitudes of mental health professionals towards this initiative remain variable. The purpose of this study was to describe mental health professionals' attitudes towards mental health consumer participation in inpatient psychiatric units. The Consumer Participation and Consultant Questionnaire was used with a non-probability sample of 47 mental health professionals from two adult inpatient psychiatric units situated in a large Australian public general hospital. Ethics approval was obtained from a university and a hospital ethics committee. Data were analysed using SPSS, Version 12. Overall, respondents had favourable attitudes towards consumer participation in management, care and treatment, and mental health planning. They were less supportive about matters that directly or indirectly related to their spheres of responsibility. The type of unit that the respondents worked in was not a factor in their beliefs about consumer participation. Recommendations are made about the development of guidelines for consumer participation in inpatient units, the educational preparation of mental health clinicians, and the need for mental health professionals to reflect on, and discuss their own beliefs and practices about, consumer participation.

Challenges to midwives' scope of practice in providing women's birthing care in an Australian hospital setting: A grounded theory study.

OBJECTIVE: To identify and explore processes midwives use to exercise their scope of practice whilst caring for women during normal birth. METHODS: Strauss and Corbin's (1998) grounded theory approach was used. Data were collected from 17 midwife participants using participant observation of women's labour and birth care followed by semi-structured interviews. RESULTS: The core category of promoting normal birthing: aspiring to develop a midwife-led scope of practice conceptualises midwives working to develop their scope of practice to promote and facilitate normal birthing for women. Two interrelated categories, promoting and maintaining healthy birthing and optimising scope of practice further explicate how midwives provide woman-centred care within their scope of practice. CONCLUSIONS: The theoretical framework generates conceptual knowledge of how midwives aspire to promote healthy, safe and responsive birthing care for women in their scope of practice in a hospital setting. Findings provide greater insights into the competing perspectives of birthing care challenging midwives' capacity to provide woman-centred care, influencing the degree to which midwives are able to exercise their scope of practice in promoting normal birth.

Evaluation of disease activity markers in dogs with idiopathic inflammatory bowel disease.

OBJECTIVES: To evaluate the clinical utility of serum tumour necrosis factor-alpha, C-reactive protein and microalbuminuria as disease activity markers in canine idiopathic inflammatory bowel disease. METHODS: Dogs with chronic gastrointestinal disease for which no underlying cause could be identified were considered to have idiopathic inflammatory bowel disease and were included in the study. Serum tumour necrosis factor-alpha was assessed using a canine-specific ELISA, C-reactive protein by immunoturbidometric assay and quantitative microalbuminuria was analysed using a monoclonal antibody directed against canine albumin. The canine inflammatory bowel disease activity index and histopathologic grade were used to assess disease severity; biologic markers were then compared with the canine inflammatory bowel disease activity index and histopathologic grade. RESULTS: Sixteen dogs were included in the study. C-reactive protein level was mildly elevated in 15 dogs. Microalbuminuria was elevated in two of 15 dogs, and tumour necrosis factor-alpha was not detected in any dog tested. No correlation was found between the canine inflammatory bowel disease activity index and C-reactive protein or microalbuminuria or between histopathologic grade and C-reactive protein or microalbuminuria. There was no correlation between histopathologic grade and the canine inflammatory bowel disease activity index. CLINICAL SIGNIFICANCE: Although only a small number of dogs were evaluated, this study does not support the use of serum tumour necrosis factor-alpha measured by canine-specific ELISA or microalbuminuria in the evaluation of disease activity in dogs with idiopathic inflammatory bowel disease. Although mildly elevated in most dogs, C-reactive protein did not reflect disease severity as assessed by the canine inflammatory bowel disease activity index or histopathologic grade.

Improving care planning and coordination for service users with medical co-morbidity transitioning between tertiary medical and primary care services.

WHAT IS KNOWN ON THE SUBJECT?: Mental health service users with medical co-morbidity frequently experience difficulties accessing and receiving appropriate treatment in emergency departments. Service users frequently experience fragmented care planning and coordinating between tertiary medical and primary care services. Little is known about mental health nurses' perspectives about how to address these problems. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Emergency department clinicians' poor communication and negative attitudes have adverse effects on service users and the quality of care they receive. The findings contribute to the international evidence about mental health nurses' perspectives of service users feeling confused and frustrated in this situation, and improving coordination and continuity of care, facilitating transitions and increasing family and caregiver participation. Intervention studies are needed to evaluate if adoption of these measures leads to sustainable improvements in care planning and coordination, and how service users with medical co-morbidity are treated in emergency departments in particular. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Effective planning and coordination of care are essential to enable smooth transitions between tertiary medical (emergency departments in particular) and primary care services for service users with medical co-morbidity. Ongoing professional development education and support is needed for emergency department clinicians. There is also a need to develop an organized and systemic approach to improving service users' experience in emergency departments. ABSTRACT: Introduction Mental health service users with medical co-morbidity frequently experience difficulties accessing appropriate treatment in medical hospitals, and often there is poor collaboration within and between services. Little is known about mental health nurses' perspectives on how to address these problems. Aim To explore mental health nurses' perspectives of the experience of service users with medical co-morbidity in tertiary medical services, and to identify how to improve care planning and coordination for service users transitioning between tertiary medical and primary care services. Method Embedded within an experience-based co-design study, focus group discussions were conducted with 17 emergency department nurses and other clinicians, in Melbourne, Australia. Results Three main themes were abstracted from the data: feeling confused and frustrated, enhancing service users' transition and experience and involving families and caregivers. Participants perceived the service user experience to be characterized by fear, confusion and a sense of not being listened to. They highlighted that service users' transition and experience could be enhanced by facilitating transitions and improving coordination and continuity of care. They also emphasized the need to increase family and caregiver participation. Conclusion Our findings contribute to knowledge about improving the way service users are treated in emergency departments and improving care planning and coordination; in particular, facilitating transitions, improving coordination and continuity of care and increasing family and caregiver participation.

Peers experience of delivering a problem-solving programme to enhance antipsychotic medication adherence for individuals with schizophrenia.

ACCESSIBLE SUMMARY: No research has been conducted into the experience of peer support in improving adherence with oral antipsychotic medication for consumers with schizophrenia. Altruism influences peers to participate in peer support. Engagement in peer support can be challenging and rewarding for peers, and helps improve their own confidence and well-being. ABSTRACT: Many consumers with schizophrenia are reluctant to take their prescribed antipsychotic medications; however, non-adherence can lead to relapse. The aim of this study was to evaluate peers' perspectives of their participation in a problem-solving peer support programme to enhance adherence in consumers who are reluctant to take antipsychotic medication. Peers contacted consumers by a weekly telephone call for 8 weeks, and used a problem-solving approach to inform their discussion about medication adherence. Semi-structured qualitative interviews were used to evaluate peers' perspectives of their involvement in the programme. Three main themes were abstracted from the data: motivation to participate in the study, experience of peer support programme, and rewards and challenges of the peer experience. Helping others was an important motivator for peers in agreeing to participate in the study. Telephone delivery was a convenient way to deliver the peer support programme. However, at times, it was difficult to contact consumers by telephone and this caused some frustration. Despite these difficulties, peers recognized that being involved in the programme increased their confidence and made them feel worthwhile. The findings have implications for the use of peer support as an adjunct intervention to promote medication adherence in consumers with schizophrenia.

Social climate of acute old age psychiatry inpatient units: staff perceptions within the context of patient aggression.

Patient aggression occurs in old age psychiatry and is contrary to their recovery and to the well-being of staff. A favourable social climate can contribute to a reduction in aggression. The aim of this study was to examine the perceptions of clinical staff about the social climate of acute old age psychiatry inpatient units. Eighty-five clinicians were recruited from these facilities. They completed a survey questionnaire about the social climate or ward atmosphere of inpatient units. The findings showed that, to some extent, respondents' perceived patient cohesion and mutual support were evident, units were perceived somewhat positively as safe environments for patients and staff, and the ward climate helped meet patients' therapeutic needs. Overall, clinicians were somewhat positive about the social climate of the units, and this has implications for the perception of aggression in old age psychiatry inpatient settings. As there is a direct relationship between social climate and aggression, clinicians should consider adopting a broad-based, person-centred approach to the promotion of a favourable social climate in old age psychiatry inpatient settings.

Nurses' experiences of restraint and seclusion use in short-stay acute old age psychiatry inpatient units: a qualitative study.

Restraint and seclusion are often ineffective and can affect patients adversely. In this study, we explored nurses' experiences of restraint and seclusion in short-stay acute old age psychiatry inpatient units and how these experiences underpin resistance to eliminating these practices. Qualitative interviews were conducted with nurses in three old age psychiatry units in Melbourne, Australia. The results provide one overarching theme, lack of accessible alternatives to restraint and seclusion, indicating that nurses believe there are no effective, accessible alternatives to these practices. Three related themes contribute to this perception. First, an adverse interpersonal environment contributes to restraint and seclusion, which relates to undesirable consequences of poor staff-to-patient relationships. Second, an unfavourable physical environment contributes to aggression and restraint and seclusion use. Third, the practice environment influences the adoption of restraint and seclusion. The findings contribute to the limited evidence about nurses' experiences of these practices in short-stay old age psychiatry, and how account needs to be taken of these experiences and contextual influences when introducing measures to address these practices. Policies addressing these measures need to be accompanied by wide-ranging initiatives to deal with aggression, including providing appropriate education and support and addressing ethical and workplace cultural issues surrounding these practices.

A collagen peptide motif activates tyrosine kinase-dependent calcium signalling pathways in human osteoblast-like cells.

A collagen peptide motif (DGEA) which is a putative alpha 2 beta 1 integrin binding site was examined for its ability to activate Ca2+ signalling pathways in the human osteoblast-like cell line SaOS-2. We show that these cells express both alpha 2 beta 1 integrin subunits (by immunocytochemistry) and that an anti-beta 1 monoclonal antibody (DF5) mobilizes Ca2+ in these cells. DGEA elevated intracellular Ca2+ in fura-2-loaded cells, in a concentration- and sequence-dependent fashion, with an EC50 of 250 microM. The tyrosine kinase inhibitor herbimycin A reduced the number of cells responding to DGEA and to transforming growth factor alpha. Thrombin also stimulated a rise in intracellular Ca2+, but the number of cells responding was not reduced by herbimycin A. The DGEA response was dependent on extracellular Ca2+, but was not due to Ca2+ influx, since it was blocked by thapsigargin and not by lanthanum. Using three different anti-alpha 2 monoclonal antibodies, we were unable to show that the DGEA-induced Ca2+ signal was mediated by the alpha 2 beta 1 integrin. In summary, the DGEA collagen motif does appear to activate receptor-mediated Ca2+ signalling events in SaOS-2 cells, in a divalent cation-dependent manner, but we were unable to demonstrate a role for alpha 2 beta 1 integrin in this response.

Cytokines increase neonatal cardiac myocyte calcium concentrations: the involvement of nitric oxide and cyclic nucleotides.

Neonatal rat cardiac myocytes were treated with cytokines, with or without the nitric oxide synthase (NOS) inhibitors N-monomethyl-L-arginine (LNMMA) and N-nitro-L-arginine methyl ester (LNAME), and systolic and diastolic calcium levels were measured by fluorescence spectrophotometry and confocal microscopy. Time-dependent changes following interferon-gamma (IFN-gamma) treatment revealed a continuing increase in intracellular calcium, which was reduced with LNMMA, but not with LNAME. Increases in calcium also occurred with interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha), but not to the extent seen with IFN-gamma. Increased cyclic guanosine monophosphate (cGMP) was involved in the results described with short-term (2 hr) TNF-alpha and long-term (18 hr) IFN-gamma treatments. Short-term exposure to IFN-gamma produced an increase in cyclic adenosine monophosphate (cAMP) and also an initial increase in the myocyte-bearing rate, with calcium levels either (i) subsequently returning to control levels while maintaining a fast beating rate or (ii), retaining a high systolic calcium level, but beating at control rates. Treatment with both IL-1beta and IFN-gamma stabilized the beating rate of the cells on some occasions. Shortening of myocytes increased with isoproterenol and following treatment with IFN-gamma, while isoproterenol stimulation of IFN-gamma-treated cells revealed increased contractile activity after short, but not long, treatment. LNMMA, but not reduced the increased contractile response with short-term IFN-gamma treatment. Our findings suggest that TNF-alpha acts via a cGMP-dependent pathway, whereas the actions of IFN-gamma involve adenylate cyclase, and possibly a NO-forming mechanism and cGMP pathway as well. It is also apparent that the two NO inhibitors function via different mechanisms or that LNMMA has a direct effect on the calcium-signaling pathway.

Use of pertussis toxin to investigate the mechanism of action of prostaglandin F2 alpha on the corpus luteum in sheep.

Pertussis toxin catalysed the ADP-ribosylation of a protein of M(r) 40,000 in ovine luteal tissue. Ribosylation of 45% of this protein in whole cell incubations (as judged by subsequent ribosylation of cell-free preparations in the presence of [32P]NAD) attenuated the prostaglandin (PG)F2 alpha-stimulated hydrolysis of [3H]inositol-labelled phosphatidylinositol-4,5-bisphosphate into inositol trisphosphate by 60%, but did not affect the inhibition by PGF2 alpha of LH-stimulated accumulation of cyclic AMP. It is concluded that activation of phospholipase C by PGF2 alpha involves a pertussis toxin-sensitive protein, probably a G protein, and that the inhibitory effect of PGF2 alpha on LH-stimulated adenylate cyclase is unlikely to be directly mediated by such a protein.

Effects of prostaglandin F2 alpha and other potential secretagogues on oxytocin secretion and second messenger metabolism in the ovine corpus luteum in vitro.

Release of oxytocin by sliced or minced sheep luteal tissue in vitro was stimulated up to 1.6- and 2.3-fold by arachidonic acid and the calcium ionophore A23187 respectively. Prostaglandin (PG) F2 alpha and the PGF2 alpha analogue cloprostenol, and other potential agonists known to be active in vivo, including noradrenaline and acetylcholine, were ineffective, as was the phorbol ester tetradecanoylphorbol acetate (TPA). The ineffectiveness of PGF2 alpha was not due to a general unresponsiveness of the tissue in vitro, as PGF2 alpha reduced LH stimulation of tissue concentrations of cyclic AMP and activated inositol lipid hydrolysis. The effect of arachidonic acid was accompanied by release from the tissue of the cytosolic enzyme lactate dehydrogenase (at arachidonic acid concentrations below those required to release oxytocin) and its effect on oxytocin and lactate dehydrogenase release was mimicked by oleic and linolenic acids; arachidonic acid was concluded to act by a non-physiological physicochemical effect without conversion to an eicosanoid. As PGF2 alpha in vitro is known to raise intracellular Ca2+ concentrations in the large luteal cells that secrete oxytocin, and as A23187 stimulates oxytocin release in vitro in the presence and absence of TPA, it is concluded that in-vitro incubation results in an artifactual blockade of the oxytocin-releasing action of PGF2 alpha at an unidentified point distal to the effect on intracellular Ca2+.

IgE predicts future nonfatal myocardial infarction in men.

Established risk factors cannot explain all the variance in coronary heart disease (CHD). Immunoglobin E (IgE), a mediator of allergy, can affect platelets and arterial smooth muscle. We previously demonstrated a cross-sectional association between IgE and cardiovascular disease (CVD) in men. The present study evaluated this relationship prospectively in 278 men and 343 women followed for a mean of 8.9 years. There was an association between IgE and coronary disease in men, but not in women. There was no association for CVD, stroke, or all-cause mortality. The age-adjusted relative risk (RR) for coronary mortality in men with baseline IgE > or = 200 kU/L was 1.66 (p < or = 0.66), but for nonfatal myocardial infarction (MI) it was 6.46 (p < or = 0.01). This association was independent of smoking and other risk factors, and unrelated to allergy. Thus, elevated IgE was a strong independent prospective risk factor for nonfatal, but not fatal, MI in men.

After-hours telephone calls to obstetrician-gynecologists.

OBJECTIVE: To characterize the pattern, content, and management of after-hours telephone interactions between obstetrician-gynecologists and patients. METHODS: In a prospective observational study, 12 resident and nine private physicians practicing obstetrics and gynecology completed data cards for after-hours telephone interactions with patients. Chief complaints were categorized as related to either women's health or primary care and on whether women were pregnant, postpartum, or not pregnant. Triage dispositions (evaluate now, office follow-up, or home care) were compared between groups. Women also were asked what they would have done if they had been unable to contact their physicians by telephone. RESULTS: One hundred ninety-two of 276 calls evaluated (69. 6%) were from pregnant women, 20 (7.2%) were from postpartum women, and 64 (23.3%) were from nonpregnant women. Calls were related to primary care health issues in 24.1% (n = 45) of pregnant women, 40% (n = 8) of postpartum women, and 28.1% (n = 18) of nonpregnant women. There were no differences between residents and private physicians in the proportion of women triaged to immediate evaluation for pregnancy (35.1% [n = 40] versus 41.9% [n = 31], P =.74) or postpartum (11.1% [n = 1] versus 10% [n = 1],P =.96) problems. Among 139 women triaged to office follow-up, 41% (n = 57) would have come to the hospital for emergency evaluation if they had been unable to reach their physicians. CONCLUSION: Resident and private obstetrician-gynecologists provide primary care and women's health care advice during after-hours telephone calls from patients. More than one third of after-hours telephone calls from pregnant women are triaged to immediate evaluation.

Hypnotically induced pseudomemories--sampling their conditions among hypnotizable subjects.

Three studies are reported in a program of research that investigated a range of parameters affecting individual differences in the incidence of hypnotically induced pseudomemory among hypnotizable subjects. Study 1 replicated Laurence and Perry's (1983b) base rates for hypnotically induced pseudomemory response among hypnotizable subjects; in Study 2 the same response was analyzed under more strictly controlled stimulus conditions. Study 3 was an investigation of the impact of a broader range of stimulus events on response and a more sensitive test of the hypothesis that individual differences in pseudomemory effects are tied essentially to the social context of hypnosis. In all three studies, independent groups of subjects were tested who were highly responsive to hypnotic suggestion. Data indicated that the incidence of pseudomemory response was stable and consistent when stringent criteria of scoring were adopted. Also, for some subjects, real and suggested memories were maintained at one and the same time when hypnotically induced memory was examined in different test settings, suggesting that pseudomemories do not permanently overlay real experience. Overall, contextual factors appeared to play a major role among susceptible subjects in determining the nature and incidence of hypnotically induced pseudomemories.

Effects of a preventive cardiology curriculum on behavioral cardiovascular risk factors and knowledge of medical students.

We evaluated a Preventive Cardiology Academic Award (PCAA) program designed to integrate preventive cardiology concepts into the medical school curriculum. Diet, preventive cardiology knowledge, preventive cardiology attitudes, exercise behavior, and body mass index were compared at entrance to medical school and during the graduation year. Complete data were available on 94 students (65 men and 29 women). Similar data from students who graduated in 1987, prior to the introduction of the PCAA curriculum, served as a control. Women showed a significant enhancement in attitude towards cardiovascular disease (CVD) prevention, while both men and women significantly increased their knowledge about CVD prevention. The frequency of planned physical activity decreased significantly in both sexes and men showed a significant increase in body mass index. Men significantly reduced total calories, percent of calories from fat and saturated fat and dietary cholesterol and increased fiber intake. In women, the only significant reduction was in total calories. In comparison to the control class that did not have the program, men receiving the PCAA curriculum reduced dietary cholesterol, dietary fat, saturated fat and monounsaturated fat. Changes in these dietary parameters were nonsignificant for women in comparison to the control class women. Additional analyses showed no systematic secular trends in dietary or other variables in classes entering from 1986 to 1990. We conclude that the PCAA curriculum changes have favorably affected the preventive cardiology knowledge, attitudes and diet of medical students.

Advancing self-determination with young adults who have schizophrenia.

The research examined how community mental health nurses promote self-determination with clients who are experiencing an early episode of schizophrenia. The study used grounded theory methodology incorporating interviews and observations. The study took place in the community, in rural and regional New South Wales, Australia, and involved clients and community mental health nurses. The findings show that the promotion of self-determination is dependent on nurses educating clients about their illness and well-being, and fostering self-control. The development of a reciprocal relationship, or alliance, between nurses and clients is implicit in advancing self-determination. The implications of the promotion of client self-determination for education, clinical practice and research and these are discussed.

Community mental health nurses and authority to prescribe medications: the way forward?

This paper explores a single dimension of the nurse practitioner role - whether community mental health nurse practitioners should have authority to prescribe medications. The paper is taken from a larger study about how these nurses promote wellness with clients experiencing an early episode of psychotic illness. The focus is timely as several Australian States have recently passed nurse practitioner legislation. This qualitative study used interviews and participant observation to collect data. The fieldwork was undertaken in the community, in regional and rural New South Wales, Australia and involved community mental health nurses. The findings show that expanding the nurse practitioner role to include authority to prescribe medications is currently contentious. Respondents envisaged that prescribing authority would include most medications that are used to treat mental illness but exclude drugs that treat medical illness. They identified a need for an appropriate educational course, and called for a system of clinical supervision and ongoing support for nurses assuming this role. Participants also claimed that individual nurses who choose to forgo prescribing authority should not be coerced into undertaking this role. The findings have professional, clinical, legal and educational implications for nurses as they seek authority to prescribe within the context of a nurse practitioner role and these are discussed.

Cancer incidence and mortality in Grenada 1990-2000.

This paper summarizes and discusses the available cancer incidence (1996-2000) and mortality data (1990-2000) for the tri-island Caribbean nation of Grenada, Carriacou and Petit Martinique. Data for the analysis came from three sources: the Grenada Department of Statistics, the histopathology specimen books from St George's General Hospital and the Death Registry of the Ministry of Health, Grenada. The age-standardized rates (ASR) per 100 000 for all cancer sites combined were 170.2 in females and 158.2 in males. The four most frequent diagnoses (ASR) by cancer site in females were cervix (60.7), breast (49.1), uterus (28.4) and skin (13.3); and among males, prostate (61.4), bladder (16.3), skin (19.3) and stomach (10). Age-standardized mortality rates per 100 000 for all cancer sites combined were 105.4 in females and 165 in males. The four most frequent cancer associated mortalities (ASR) in females were breast (17.9), uterus (11.2), colon (10.3) and cervix (9.7); and among males, prostate (53.6), lung (18.7), stomach (14.5) and colon (10.9). This study found statistically significant spatial trends for overall cancer mortality and temporal trends in incidence and mortality rates for prostate and for incidence rates of stomach cancer. These rates are compared with those from other areas in the Caribbean and the United States of America and encourage efforts to establish a cancer registry in Grenada.

Coping strategies in carers of young people with a first episode of psychosis.

BACKGROUND: Carers of young people with first episode psychosis (FEP) often face burden. Understanding ways in which carers cope is not only important for providing support to them but might maximise patient outcomes. The aim of this study was to examine strategies carers use to cope with the burden of caring for a young person with FEP. METHODS: The study was part of a randomized controlled trial focusing on the effectiveness of a problem-solving bibliotherapy intervention for carers of FEP patients, in terms of promoting coping and reducing psychological distress. Baseline data on the Ways of Coping (WOC) scale was available for 124 carers aged between 18 and 66 years. Principal component analysis with PROMAX rotation was used to determine the number of factors that could be used to characterise coping behaviour. Regression analyses were used to determine how the factors were related to carers' demographics, burden, psychological well-being and expressed emotion. RESULTS: Approximately half of the carers reported that they frequently use positive coping techniques such as self-talk, active problem solving, and positive reframing. The factor analysis yielded five factors: (i) cognitive-escape coping; (ii) optimistic coping; (iii) seeking connections; (iv) tension reduction; and (v) distancing. The relationships between these factors and demographic characteristics, carers' perception of burden, expressed emotion, and psychological distress are reported. CONCLUSIONS: Avoidance coping strategies are related to psychological distress, emotional over-involvement, and increased carer burden. Interventions facilitating the use of adaptive problem solving and positive re-appraisal will promote carer coping and reduce psychological distress.