The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

There is no clear limit between the personal and professional dimension, when the health worker cares for patients who have no prospect of cure. This shadowing of the personal dimension causes high emotional demands of the professional in the face of the experiences with the death.

In face of troubles which surround the nurse in the context of death, this article aimed to identify the learning and self-care practices experienced by nurses who work with patients in risk or in death process, in a haematology-oncology unit.

This is a clinical-qualitative study, conducted through individual interviews. The participants were 6 nurses from haematology-oncology unit of a university hospital, covering the sectors of chemotherapy clinic and children's unit.

The results highlight two phenomena built by the experiences of nurses: long learning experiences with the team work through the maturity arising over time or even with constant monitoring of the death situations; and self-care practices as self-preservation phenomenon through the development of pain by speaking and listening in groups, the motivation through professional achievement and the well-being caused by the charity care each other.

Work towards the personal development of nurses as professional who deals with ethical conflicts should be focused on promoting opening spaces for speaking and listening of these nurses. This allows them to create ways of dealing with situations of death, which are professionally responsible.

The authors have not supplied their declaration of competing interest.

Each individual experience cancer in a different way. While some perceive cancer as a complex and traumatic experience by developing some psychosocial and additional physical problems, others overcome cancer-related difficulties by gaining benefits such as post-traumatic growth (PTG) owing to their resilience. Resilience and PTG that are very valuable concepts in human life to adapt positively to cancer process have relations which need to be better understood.

We aimed to provide a better understanding of relations between resilience and PTG and relations of these two concepts with cancer experience.

Literature review.

Successful adjustment to life-threatening illnesses such as cancer, require resilience. On the other hand, resilience provides a barrier toward stressors by helping improvement of PTG and so, is an antecedent factor of PTG. PTG ensures a deeper perspective and strength to people after traumatic events. Hence, individuals having higher levels of PTG feel powerful enough to handle the problems in their life and can easily adapt to cancer process by focusing on the positive outcomes of trauma, having improved coping mechanisms and an improved psychological well-being.

Resilience and PTG have strong mutual relations and this phenomenon should be considered for a qualified cancer care.

The authors have not supplied their declaration of competing interest.

To identify possible change patterns or robustness in sources of meaning in family caregivers of pre-terminal patients after onset of support at home by an outreach palliative nursing team during a survey period of three months.

One hundred caregivers of terminally ill patients were included in a prospective observational trial. The Sources of Meaning and Meaning in Life Questionnaire (SoMe) was administered at four points of measurement: T0 (immediately before onset of palliative care); T1 (one week after T0); T2 (one month after T0); T3 (three months after T0). Descriptive statistics, random effects regression analyses; multivariate linear and quadratic regression models were performed for the full (n = 100) as well as for the reduced sample (n = 24).

Growth curve analyses reveal significant parabolic changes for the dimension “order” and for the subscales “social commitment”, “tradition”, “morality”, and “fun”. All other dimensions or subscales remained stable during the time of the study. Cross-sectional multivariate regression models (T0) showed negative associations of some dimensions with patients’ age and psychological burden of the family caregiver while psychological burden of patients was found to be positively associated with some dimensions. No significant effects of interaction variables with time (linear and quadratic).

With few exceptions, family carers seem to keep a stable sense of meaning in life during the final stage of their relatives’ terminal illness. Particular associations between sources of meaning and age of patients as well as psychological burden both of patients and carers have to be taken into consideration in support planning.

The authors have not supplied their declaration of competing interest.

Sleep disturbances are common among cancer patients. Especially during hospitalization, not only adverse medical conditions but also ward environments can affect sleep. We have developed a program of sleep-hygiene education and sleeping pill reduction for inpatients (the i-sleep program) and applied it to cancer patients. This study aimed to explore the effect of the program.

In a general hospital with 2,715 beds, we estimated the proportion of inpatients prescribed hypnotics at admission to and discharge from the department of oncology before (2014) and after (2015) the program. In addition, we estimated the proportion of inpatients prescribed hypnotics among all inpatients in the department of oncology on the first day of each month of 2014 and 2015.

A total of 12,382 patients (2014, before) and 12,313 patients (2015, after) were admitted to oncology department of Asan Medical Center. The proportion of inpatients prescribed hypnotics as discharge medication among inpatients who had been prescribed them at the time of admission decreased significantly, from 76.0% (2014) to 69.8% (2015), after the program (RR = 0.92, 95% CI: 0.87–0.98). The proportion of inpatients newly prescribed sleeping pills after admission to the hospital did not significantly decrease (4.03% to 3.98%; RR = 0.99, 95% CI: 0.87–1.12). The mean prescription rate of sleeping pills per day was 10.02% in 2014 and 7.99% in 2015 (P = 0.03).

Although the i-sleep program did not reduce the prescription rate of sleeping pills per day, it effectively reduced the proportion of cancer patients who continued to take sleeping pills from admission until discharge.

The authors have not supplied their declaration of competing interest.

Old people with diabetes are more likely to develop cognitive impairment, Alzheimer's disease and vascular dementia. However, the determinants of the association between diabetes and cognitive impairments are only partially known.

To evaluate cognitive disorders in elderly diabetic patients and to identify risk factors of cognitive impairment in this population.

It was a cross-sectional study. It involved outpatients aged 65 and older, who were followed for diabetes in the endocrinology department at the Hedi Chaker University Hospital in Sfax (Tunisia), from October 1 to December 31, 2015. For each patient, we collected sociodemographic, clinical and therapeutic data. We used the Montreal Cognitive Assessment (MoCA) to identify mild cognitive decline (score < 26/30).

We identified 70 patients, all with type 2 diabetes. The average age was 66.8 years. The sex ratio (M: F) was 0.7. The mean duration of diabetes was 14.76 years. The average MoCA score was 20.68 ± 6. Forty patients (57%) had cognitive decline. The cognitive impairment was statistically correlated with female sex (P = 0.02), low level of education (P = 0.00), high levels of glycated hemoglobin (Hb A1c ≥ 7%) (P = 0.00), presence of hypoglycemic episodes (P = 0.05) and presence of dyslipidemia (P = 0.00).

Our study confirmed the high rate of cognitive decline in older type 2 diabetes patients. The profile of subjects at risk was consistent with the literature: poorly controlled diabetes, severe recurrent hypoglycaemia and associated dyslipidemia. Acting on these risk factors would prevent cognitive decline and therefore progression to dementia.

The authors have not supplied their declaration of competing interest.

Fairness is a fundamental factor for prosocial behaviors and have a crucial role in social interaction. Examining fairness during maturation can shed light on different questions and hypothesis about the development of prosociality across life span.

The purpose of this study was to investigate the development of strategic planning in children and adolescents.

A total of 288 healthy students between ages 7 and 18 from four community schools participated in a one-shut run game which the participants were proposed and should set a package of offers concluded six suggestions.

Among 288 students, 128 (44.44%) participants were male and 160 (55.56%) participants were female. In first offer, 29.7% of boys suggested an unfair offer but girls with 23% were more generous. However, in last suggestion in comparison with girls (73% unfair), boys showed more generosity (64% unfair). Notably, girls in average, spent 135.78 seconds (SD = 86) to set their offers while boys needed less time to prepare their suggestions (117.16s, SD = 119.7)

According to the findings it seems that both genders start more generous offers and end up with less generous offers. In comparison with boys, girls need more time in economic decision-making and interestingly more fair options at the start of game.

The authors have not supplied their declaration of competing interest.

Neurocognitive disorders, previously not featured in the psychiatric nomenclature such as the Diagnostic and Statistical Manual of Mental Disorders (DSM), have now been included in the latest, fifth edition of the DSM. There is a dearth of studies on neurocognitive disorders among non-western population.

The aim of this study is to compare neuropsychological functioning measured by tests of executive function and cognition among patients marked by apathy and impulsivity following a traumatic brain injury in a non-Western population, Oman.

Comparing the performance of various neurocognitive indices including negativistic features and disinhibition, which were identified using the symptom checklists Apathy Evaluation Scale and Disinhibited Evaluation Scale. Comparative neurocognitive measures included tapping verbal reasoning ability (Raven's Standard Progressive Matrices), working memory (Digit Span–Digit Forward–Digit Backward); Buschke Reminding Test, planning/goal-directed (Controlled Oral Word Association Test–verbal fluency, Tower of London(–planning time–number solved), (Wisconsin Card Sorting Test–perseverative errors, and–number of categories solved), and affective ranges (Hospital Anxiety and Depression Scale).

Analysis showed that those participants who scored highly at Apathy Evaluation Scale and Disinhibited Evaluation Scale did not differ on indices measuring working memory/attention and affective ranges except for one measure: Digit span-Digit Forward. In the measures operationalized here to tap planning/goal-directed behaviour, the two cohorts differ on all indices except for Tower of London-Number Solved.

This study lays ground for further scrutiny in delineating the different characteristics of what previously labelled as frontal dysexecutive phenotype. It indicates that apathetic and disinhibited temperaments marked with specific neuropsychological performance.

The author has not supplied his/her declaration of competing interest.

Flupirtine is used in many European countries for the treatment of different pain states because of its analgesic attributes. It is a centrally acting, non-opioid analgesic.

The aim of the study was to investigate an entire study the possibility of applying flupirtine (ktadolona) – selective neuronal potassium channel activators in the treatment of pharmacoresistant epilepsy and related non-psychotic depressive disorder in adults.

A total of 20 patients with the diagnosis of primary – generalized idiopathic epilepsy (IGE) and “non-psychotic depressive disorder due to epilepsy (F06.362)”. Before applying katadolon forte, patients received standard antiepileptic and antidepressant drugs (Depakine-Chrono 1000 mg/day, 150 mg lamotrigine/day, levitiratsetam 3000 mg/day of citalopram 20 mg/day). Assigning a first katadolon fote 14 days 200 mg 2 times a day, followed by 200 mg three in day inside.

Of the 20 patients, 10 had no seizures, 8 marked decrease in the frequency of seizures in 2 patients therapy was not effective.

Our data should be considered preliminary, because small sample of patients and duration of follow-up (18 months). The next phase of work will be carried out on a large sample of patients and a longer observation, placebo – controlled, double blind study.

The authors have not supplied their declaration of competing interest.

Understanding violence as a public health problem brings as required its inclusion in the curricula of undergraduate courses in health.

To describe the approach to the topic of violence and the teaching strategies used by teachers of undergraduate courses in nursing of two public higher education institutions of the State of São Paulo, Brazil.

Knowing the approach to the topic of violence in two nursing under graduation courses.

Descriptive, exploratory qualitative study. For data collection, semi-structured interview was used; were subject of the study, 15 teachers of the institutions studied that ministered courses whose programs contained the word “violence” or related. The data were subjected to analysis of the “collective subject discourse”.

The results referred to speeches about the importance of addressing violence in theory and practical course, the experience of violence in the everyday practice and pedagogical strategies in the theoretical and practical learning. Teachers recognize the importance of violence be crafted at graduation, describing that, although not always appear in the formal curriculum, the subject appears in an informal way in academic training. Recognize, however, that there is a fragmentation in the approach of the theme, because teachers are divided between theoretical and practical classes and not all of them study the subject.

It is essential that there should be more discussions on violence among teachers as well as be designed strategies to better approach the theme at graduation.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The roots of social phobia, lay in the social nature of human beings who fulfil their basic needs in social relations. By the definition, it is the fear of witnessing the negative judgement and the criticism of other people, which is so intense that, is followed by reactions of avoidance of phobic situations and doings, followed by intense vegetative symptoms.

Introduce social phobia as an important social and medical problem with common co-morbidity and exceptional risk of suicide. At the same time it gives special accent to the diagnostic procedures and differential diagnosis.

Analysis of the information from literature and practice and coming to conclusions with the inductive method.

Social phobia is a chronicle illness, equally present in both sexes. The central position is taken by all-the-time present intense irrational fear. Alcoholism, misuse of sedatives, depression, and panic with agoraphobia, OCD are common followers of social phobia. Differential diagnosis witch eliminates panic with agoraphobia, or just the lack of social skills allows the right therapeutic approach.

Social phobia, alone or combined with other disorders, has a huge medical and social value. Coming back to regular life tracks depends on the right diagnosis and the right time to go into the healing process.

The authors have not supplied their declaration of competing interest.

Since the presentation of the symptoms of postnatal depression (PND) can vary; healthcare professionals must receive the appropriate level of training to develop the knowledge required for the effective assessment and referral of women. Yet, healthcare professionals may have limited knowledge in perinatal mental health and students may lack practice opportunities to develop the knowledge and clinical skills. For these reasons, the use of alternative learning resources within perinatal mental health education is vital.

To explore the use of visual media in perinatal mental health education.

Against the background of increasing concerns about the ability of professionals to assess women with PND, this paper will consider how using dramatisation as a teaching approach can enable students to develop their knowledge and guide clinical skill development.

Three separate groups of senior student midwives and health visitors were asked to evaluate a dramatisation developed from women's lived experience of PND. Pre and post verbal evaluation of the drama were undertaken with the use of focus groups guided by semi-structured questions. Ethical approval was granted by the university.

Following thematic analysis three issues were identified:

–the role of the healthcare professional;

–improvements needed in care;

–issues of education and training.

Against the background of limited placement experience and opportunity for assessment of PND, the use of visual media can improve student healthcare professionals’ learning; with the use of structured facilitation, there is a great potential for multidisciplinary learning.

The authors have not supplied their declaration of competing interest.

Since the advent of online streaming television, a new behavioural phenomenon have emerged among millennial, named “binge watching” that is viewing more than two episodes of a TV show in the same sitting. Whether or not this behaviour reflects emotional difficulties has been poorly studied.

Describe the phenomenon and search a possible link with depression and anxiety.

Fifty medical students were recruited. A questionnaire exploring the circumstances, the purpose and the outcome of the binge viewing was fulfilled. The Beck depressive inventory and the state-trait anxiety inventory were passed for the assessment of depression and anxiety.

Among the 50 students questioned, 68% met the criteria of binge viewers and 64.7% of them adopted this behaviour at least once a week with an overall average of screen exposure of 3.8 hours in one sitting. Before the binge watching, 35.3% reported excitement and 29.4% boredom and have used it mostly to pass time (47.1%) and for fun (44.1%). Participants have felt more relaxed and happier after the viewing. Mild depression was found in 10 cases and moderate depression in 5 cases. Anxiety scores averaged 35.38 for state anxiety and 40.32 for trait anxiety. An inverse relationship was found between depression and anxiety scores and the frequency of the binge watching and its exposure duration. The correlation was hover non significant.

Could it be that the binge watching is a means of fighting against anxiety and depression rather than an evidence of emotional difficulties? Further studies are needed.

The authors have not supplied their declaration of competing interest.

Drawing tests provide good opportunity to research potential risks in emotional and personal development of a child with speech disorder, because drawing tests almost do not involve speech.

The research was aimed at detecting potential risks in emotional and personal development of children with speech disorders. The study involved 28 children (15 girls and 13 boys) with moderate speech disorders and 30 normally developing children. All the children attended kindergarten and were of age 5.5 years at the moment of the research.

The following methods were used: non-participant and participant observation, expert assessment, structured interview with educators, individually conducted family drawing test.

Most children (86%) expressed willingness to perform a task, in some cases (14%) children failed to perform a task because of emotional numbing. The children's perception of a specialist was marked by increased anxiety and stress, in some cases it was expressed in a drawing by filled areas (38%) or by barely visible figures (62%). Most children (87%) tried to demonstrate their abilities and were diligent, but their drawings were generally poorer than that of normally developing children. This phenomenon reflects deficit of skills, imagination deficit and low level of aspiration. Quality of drawings and their visible from differ from the drawings of normally developing children that indicates low self-esteem and feeling of personal incapacity formed by speech disorder.

Increased anxiety, constriction and imagination deficit characterize children with speech disorders. Their emotional attitude to speech behavior influences their graphical self-fulfilment.

The authors have not supplied their declaration of competing interest.

Homelessness is a phenomenon, which is hard to limit, as it contemplates different situations including roofless and squatters.

To determine the presence of these homeless categories in the city of Girona and examine the prevalence of diagnosed mental pathology and its principal socio-demographic characteristics.

Transversal, observational and analytic study of the population of roofless people and squatters. The registers of the outreach street work team, the local police and the public shelter were used in order to detect the cases and their basic socio-demographic characteristics. The clinical record of the mental health and addiction public network was accessed to determine their diagnosis.

During the 6 years of registers, 781 cases of people in situation of roofless and squatters were detected. In total, 83.2% (n = 630) of the cases were men and 16.8% (n = 131) women. The average age was 44.8 (ED = 11.2) and no differences were found regarding gender (Men = 45.3, ED = 11.0 vs. Women = 42.9, ED = 12.2; t = 1.7, df = 405, P = 09). However differences were found regarding origin (Immigrants = 42.2 years, ED = 10.3 vs. Natives = 46.8 years, ED = 11.4; t = -4.2, df = 402, P < .001). A total of, 52.9% of the cases (n = 412) displayed diagnosed mental pathology and 15.8 (n = 123), dual pathology.

Mental pathology is more prevalent among this typology of homeless people than in general population, as other studies prove.

The authors have not supplied their declaration of competing interest.

There exists a great number of empirical studies which refer as causes of homelessness not only individual factors such as mental disorders or addictions, but also structural factors such as poverty rates or unemployment.

To describe the evolution of the prevalence of homelessness in Girona from 2006 to 2015, and compare it with the evolution of unemployment in the same region.

The absolute number of homelessness is obtained from the official records in the city of Girona, which include the data of the open medium intervention team, the local police, and the specific municipal hostel. The rates are calculated on the annual totals of population. Correlations are used to compare quantitative variables.

The yearly homelessness rates increased progressively from 2006 to 2014, the year in which they began to decrease. Similarly, unemployment both in Spain and in the city of Girona in particular evolves in a similar way, with the burden of the worldwide economic crisis. There exists a positive correlation between the evolution of homelessness in Girona and unemployment both in Spain (r = 9.4, P < .001) and in Girona (r = 9.5, P < .001).

The effect of the economic crisis affects the people who are socially excluded in a direct way. These results prompt the investigation of the causes of homelessness, which in many cases are attributed to the responsibility of the individuals.

The authors have not supplied their declaration of competing interest.

Font de la Pólvora is a neighbourhood located on Catalonia, which has been one of the most important points of sale of heroin and cocaine in the country. The sale of drugs was also affected by the economic crisis, changing the behaviour pattern of patients with drug dependence.

To describe the changes in drug trafficking in this region and how these influence their consumption.

The investigation is carried out by the harm reduction outreach team, who selected, with a non-probabilistic method, a sample of 6 drug users. An in-depth semi-structured interview was conducted.

From 2006 to 2012, there existed up to 19 points of drug sale of heroin and cocaine. There are currently 2. The reasons behind the decrease are:

–the demand for cocaine decreases;

–the sporadic consumption of heroin decreases;

–with the decrease in demand, drugs lose quality.

With the housing bubble in Spain and the rise in foreclosures on behalf of banks, empty flats proliferated in the area, which were eventually occupied illegally. This fact prompts the production of cannabis.

Many of the strictly punitive actions in the control of narcotics lead to the dealers coming up with new ideas and new patterns of consumption which complicate the intervention of the teams working in the territory.

The authors have not supplied their declaration of competing interest.

Animal hoarding is considered an under-reported problem, which affects the welfare of both people and animals. Few reports on animal hoarding are available in scientific literature, particularly outside North America.

We designed a study to analyse cases of animal hoarding in Catalonia.

We wanted to expose the presence and consequences of this disorder in our area and to check for cross-cultural similarities with previous studies in other countries.

Data was obtained retrospectively from 23 case reports of animal hoarding in Catalonia collected by city councils and the Catalonian police from 1992 to 2015.

Thirty-three people (20 women and 13 men) and 1521 animals, mainly dogs and cats, were involved. Most cases (n = 13) involved a sole animal hoarder. Most cases (n = 14) were chronic (lasting longer than 5 years). Object hoarding co-morbidity was found in most cases (n = 17). All hoarders were over 40-years-old, with half of them aged over 65. Only in 4 cases was an intervention by the healthcare system reported. Most of the hoarders (9 out of 13) actively opposed animal removal. In more than 50% of cases, the hoarder's personal care, health and financial situation were precarious. No awareness of the impaired welfare of the animals was found in most cases.

To the author's knowledge, this is the first study on animal hoarding in Catalonia and one of the few available in Europe. Our results are aligned with previous research, adding evidence of cross-cultural common elements of animal hoarding.

The authors have not supplied their declaration of competing interest.