ABSTRACT
OBJECTIVES: This article aimed to address the feasibility of mentalization-based treatment (MBT) for patients with personality disorder in a non-specialist setting. The development and implementation of an MBT Programme is described. METHODS: A multidisciplinary Consult Group met to plan the implementation of the programme. Participants attended a psychoeducation group (MBT Introductory Group), then weekly individual and group therapy. Fourteen participants started the full programme with eight completing at least 9 months, complete data are available for five participants who completed 27 months (first cohort) and 21 months (second cohort). Data include quantitative measures and qualitative questionnaires/interviews. All had a diagnosis of personality dysfunction with co-morbid disorder including anxiety/depressive disorder, post-traumatic stress disorder and eating disorder. RESULTS: Data on five participants revealed reductions in global level of distress, improvements in psychological well-being, less interpersonal difficulties and better work and social functioning. Qualitative data from feedback questionnaires (n = 18) and in-depth interview (n = 2) are discussed under the themes of mentalizing, treatment feedback/outcomes and group factors. Therapist reflections on the process identify the challenges involved in implementing a specialist psychotherapy programme within a general service and learning points from this are discussed. CONCLUSIONS: MBT is an acceptable treatment for patients with personality dysfunction. Prior to the implementation of a programme, factors at the therapist, team and organizational level, as well as the wider context, need to be examined. This is to ensure that conditions are in place for proper adherence to the model to achieve the positive outcomes demonstrated in the RCT studies.
Subject(s)
Borderline Personality Disorder , Mental Health Services , Mentalization , Adult , Borderline Personality Disorder/therapy , Feasibility Studies , Humans , Mentalization-Based TherapyABSTRACT
A comparison of commonly occurring metazoan parasites in the digestive tract was made between common eiders, Somateria mollissima, that were contaminated with oil and reference birds confiscated from illegal hunting. There was a greater number of commonly occurring parasites and their abundance in reference than in oiled eiders. Except for an acanthocephalan, Polymorphus botulus, which was embedded in the wall of the intestinal tract, most of the other taxa of parasites, including trematodes, cestodes and nematodes, were probably voided from the birds following ingestion of oil. Reference eiders harboured fewer species and a substantially lower mean abundance of parasites than those studied in Newfoundland and Labrador more than four decades ago; this may be a signal of a changing prey base or an increase in prey availability as winter ice cover continues to decline.
Subject(s)
Anseriformes/parasitology , Helminthiasis, Animal/parasitology , Helminths/drug effects , Hydrocarbons/pharmacology , Intestinal Diseases, Parasitic/veterinary , Petroleum , Animals , Bird Diseases/parasitology , Female , Gastrointestinal Tract/parasitology , Helminths/classification , Helminths/isolation & purification , Intestinal Diseases, Parasitic/parasitology , Male , Newfoundland and LabradorABSTRACT
The ability of a new cyclosporine (Cs) derivative, (Nva2)-Cs (CsG), to suppress rejection of lung and heart allografts in rats was determined and compared with that of CsA. Left lungs were transplanted orthotopically; hearts were transplanted heterotopically into the abdomen. (Nva2)-Cs was used in three experimental protocols: (1) single or three (Nva2)-Cs injections given to lung-transplanted rats, (2) daily oral (Nva2)-Cs treatment at different doses compared with similar CsA treatments in heart allografted rats, and (3) An 11-day (Nva2)-Cs treatment starting at increasing intervals after transplantation of hearts. (Nva2)-Cs was found to be immunosuppressive, and effective even when the treatment started as late as four days after transplantation. However, (Nva2)-Cs was less effective than CsA in suppressing rejection of lung and heart allografts at low doses. Because (Nva2)-Cs is possibly not nephrotoxic, it might be a useful drug if used in higher doses than CsA or in combination with other immunosuppressive agents.