The aim of this study is to acquaint the readers with some pieces of practical guidance on the therapy of neurotic disorders offered by Professor Mieczysław Kaczyński to his colleagues and students at the Lublin Clinic of Psychiatry. Patients who report so-called neurotic complaints are a group that requires a very thorough clinical analysis. Professor Kaczyński emphasized that it was necessary to make a distinction among patients with a neurotic reaction, a pseudoneurotic syndrome, and ‘neurosis proper’ or psychoneurosis. The first group includes patients who report a psychological trauma as a trigger of their complaints. Therapeutic intervention brings good outcomes leading to resolution of the condition. A group of patients that is very important from the point of view of diagnosis are those in whom neurotic complaints are masking an onset of a somatic or mental illness or an existing illness which is running a mild course. In such cases, a cursory examination leading to a mistaken diagnosis of neurosis can have devastating effects. A misdiagnosis is easy to make, for example, in patients with increased intracranial pressure (“the neurasthenic stage of a brain tumour”) or an onset of a mental illness (the pseudoneurotic syndrome of early schizophrenia). Therefore, often, before the final diagnosis is arrived at, multiple follow-up examinations are needed to monitor the structure and dynamics of the disease. Only when the first two diagnostic options have been excluded, can the physician classify the disorder as a neurosis (psychoneurosis). In such cases, it is necessary to find the etiological agent, which, more often than not, is a situation of conflict or frustration that the patient is unconscious of. A failure to analyze a case in this way may result in the patient’s resignation response, potentially leading to suicide. It appears that Professor Kaczyński’s remarks on the clinical picture of neurotic disorders largely round out the information provided in ICD-10 under F.40–F.48.
Jakub Siembida, Piotr Frończuk, Justyna Morylowska-Topolska, Aleksandra Siek and Hanna Karakuła-Juchnowicz
Introduction According to the data obtained in the EZOP Poland study (2015), the prevalence of alcohol dependence in lifetime in Poland amounts to about 2.2% of the population, entailing enormous social, family and personal harm, including health damage. It is estimated that about 72% of alcohol-dependent patients complain about one or more problems related to the sexual sphere, which may result from both the development of somatic complications in the course of alcohol dependence, and from psychiatric complications that themselves can lead to sexual dysfunction. There are reports and clinical observations indicating that the occurrence of sexual dysfunction (SD) can affect the shortening or interruption of the period of abstinence.
Aim The aim of this work is to show sexual dysfunctions in alcohol-dependent men and to discuss the factors that may affect the occurrence of the above-mentioned dysfunctions.
Material and methods The available literature was reviewed using Medline, Google Scholar and ScienceDirect browsers by entering the keywords: alcohol dependence, sexual dysfunction, comorbidity, alcohol-caused diseases and time descriptors: 1979-2016.
• Alcohol dependence is associated with the occurrence of various types of sexual dysfunctions (SD).
• The diagnosis of SD should take into account all possible causes that may lead to the development of SD in this group of patients, including the comorbidity of somatic diseases or the negative impact of drugs on sexual function.
• Occurrence of SD is connected with a higher risk of abstinence interruption.
• There is a need to carry out more research in order to better understand the relationship between alcohol dependence and the prevalence of sexual dysfunctions.
Oleg Gorbaniuk, Andrij Mirowich, Władysława Leoszko, Julia Gorbaniuk, Aleksandra Kordon, Maria Świderska, Olena Kuts and Anna Korczak
The aim of the psycholexical study was to classify the terms describing individual differences in the Ukrainian language.
Method. To accomplish this objective, we analysed 220,000 entries included in a universal dictionary of Ukrainian and identified 20,024 terms – adjectives, participles, type-nouns, and attribute-nouns – used to describe human characteristics. The identified person-descriptive terms were classified by a team of five trained judges into 13 categories and subcategories. The judges’ taxonomic decisions were tested for validity and interjudge agreement.
Results. This procedure yielded lists of Ukrainian personality descriptors, consisting, respectively, of 2,426 adjectives, 2,255 participles, 1,653 attribute-nouns, and 1,474 type-nouns. The analysis of semantic redundancy of terms representing different parts of speech but having the same common morpheme among dispositional descriptors identified a total of 1,634 morphemes that differed in terms of meaning. The analysis identified 212 (22.0% of morphemes) type-nouns that could not be replaced by any different part of speech with the same morpheme to describe the same personality trait.
Conclusions. Ukrainian personality lexicon has a comparable or higher diversity of personality-descriptive vocabulary, attested to by the presence of 96% Big Factors markers from international comparative analyses of psycholexical structures of natural languages. The results of the study contribute to the debate on universals in the description of individual differences and constitute the basis for future questionnaire-based studies aimed at identifying the psycholexical structure of the Ukrainian language.
Debra Pollard, Kate Khair, Cléa Percier, Yen Wong and Robyn Shoemark
Management of haemophilia involves on-demand or prophylactic intravenous administration of recombinant or plasma-derived replacement clotting factors or bypassing agents. These products are provided as lyophilised powder and diluent, which need to be mixed to produce a solution for infusion. While this process has previously involved multiple time-consuming steps, several reconstitution systems are now available to make mixing easier and more convenient. This study aimed to investigate experience of use and perceptions of the Novo Nordisk MixPro® mixing device among patients and carers using activated recombinant factor VII (rFVIIa) or recombinant factor VIII (rFVIII) with MixPro, and nurse specialists who were either familiar or unfamiliar with MixPro. Nurses were asked to simulate the preparation of an inactive solution using MixPro. Semi-structured interviews were used to gain insight into participants’ opinions of mixing systems in general and their perceptions of MixPro. Likert scales were used to rate the performance of MixPro against predefined characteristics of mixing systems, and the importance of the predefined characteristics to the design of a mixing system. Patients/carers and unfamiliar nurses identified low contamination risk when mixing as the most important characteristic of a mixing system; the most important criterion for familiar nurses was confidence that patients/carers could prepare the system correctly. MixPro was perceived to perform very well overall, particularly in parameters identified as most important. It was described as being user-friendly, simple and quick; its compactness and portability were highlighted as advantages for storage and travel. The main disadvantages reported related to its small components. The majority of nurses said that they were highly likely to recommend MixPro to their patients.
Long-standing inhibitors present many day-today difficulties for the affected individual; the unpredictability of bleeds, bleed management, pain and treatment efficacy all affect quality of life. This study explored these issues through focus groups of affected individuals aged 16-25 in the UK. The data from the focus groups was analysed for recurring themes, which were coded under three umbrella headings: ‘daily impact’, ‘education and future’ and ‘resilience and support’. Participants felt isolated through geography and being extra ‘rare’ within the bleeding disorders community; used pain as a gauge of bleed resolution, often without use of analgesia; described transition to adult care as particularly worrying; and explained the potential impact of living with an inhibitor on future career options. Peer-to-peer networking could provide emotional support for these young adults, who could also be role models for the future. Despite the burden of living with an inhibitor and its treatment, participants described a good quality of life from their own perspectives. With new therapeutic options for these individuals on the horizon, they look forward to a future with fewer bleeds and less pain.
Haemophilia treatment is characterised by intravenous infusions of clotting factor concentrates, with nurses frequently taking the lead role in administration, patient training and patient care. In recent years, a number of novel factor and non-factor-based therapies delivered by subcutaneous injection have been developed. These therapies are now undergoing clinical trials and will shortly be available in clinical practice. The coming era of at least some haemophilia treatments being delivered by subcutaneous injection clearly represents a significant change not only for patients (for whom they may be more convenient) but also for haemophilia nurse practice, particularly with respect to bleed and surgical management plans, and hence for nurse training and education. This review describes evidence-based guidance on subcutaneous injection technique and summarises the implications for nurses.
VELSEAL-Tis an innovative haemostatic medical device for the control of bleeding. Incorporating a clotting agent (thrombin) and anti-fibrinolytic agent (tranexamic acid), it enables rapid coagulation when blood flows into the dressing, leading to sealing and stabilisation of wound surfaces. A 36-year-old known to have mild haemophilia A presented with profuse bleeding from the forehead after injury following a fall on concrete surface. He attended hospital after 18 hours of injury as bleeding continued as soon as pressure was released from the injury site. A VELSEAL-T patch was applied to the injury site with the patient’s full consent. The bleeding stopped after 60 seconds, but the patient was instructed to hold the patch in place for a further 60 seconds. After two minutes of tight pressure application, there was no more oozing of blood from the injury site. This case shows that VELSEAL-T can be used as an aid in stopping external bleeding in haemophilia patients. Further trials should be undertaken to evaluate the safety and efficacy of this product.
A person with haemophilia is at risk of intracranial haemorrhage caused by spontaneous or traumatic events, potentially resulting in long-term disability. Early initiation of timely treatment is essential to prevent this. In developing countries, morbidity and mortality is common in intracerebral haemorrhage (ICH) cases with haemophilia as a result of patients and family members having inadequate knowledge, lack of awareness regarding referral, lack of availability of treatment products, and delays in the treatment decision. These barriers can potentially be managed by the haemophilia nurse taking responsibility for the coordination of care. This case report addresses the nurse-coordinated care of a haemophilic patient with ICH in a developing country, and may provide insight into the benefits of a haemophilia nurse undertaking a coordinating role.
With improved replacement therapy, people with haemophilia (PWH) live longer, with the consequent emergence of age-related chronic diseases not previously seen in haemophilia. The prevalence of cardiovascular disease and associated complications in older PWH appears to be on the rise. Management of myocardial infarction in a person living with severe haemophilia presents a particular challenge, as treatment options often include antiplatelet therapy, anti-coagulation and invasive procedures. Current guidelines for managing acute myocardial infarction are not specifically designed for people with bleeding diatheses such as haemophilia. We present a patient with severe haemophilia A on extended half-life factor VIII prophylaxis who developed an acute ST-elevation myocardial infarction (STEMI), discuss his clinical management and highlight lessons learned.
The purpose of the paper — to present the theoretical considerations and the results of empirical study concerning on the intentional characteristics of professional consciousness (on the example of social-role attitudes of students). The structure, the dynamics of changes in the social-role attitudes of students during studies at higher educational institution in different forms of studies (full-time and part-time) and the influence of the quality of program content transferred during the education process on the shaping of students' professional awareness were also discussed.
The methodology of the research. We used the method of questioning and incomplete sentences in the research. The sample consisted of 94 students of 1 - 5 courses in the following fields: psychology, primary education, mathematics and physics. The study involved 17 part-time students and 77 full-time students. The age of full-time students was from 17 to 22 years old, and the age of part-time students was from 24 to 35 years old. Methods of mathematical statistics are used to evaluate the data.
The results of the research. The data of the empirical research of the students' social-role attitudes show that they have content peculiarities as for the specifics of manifestation at different stages of professional training and on different forms of studies at higher educational institution. Social attitudes regarding the role of “student” and the role of “professional” which have three-component structure (cognitive, emotional and behavioural) vary in degree of awareness and completeness, and are ambivalent. This increases their resilience to changes.
The discussion. The results of the studies show that the social-role attitudes undergo changes as a result of target influences in the process of professional training of future specialists at higher educational institution. Therefore, the definition of social-role attitudes features will contribute to the development of the effective technologies in the professional training of specialists.