Episode 1.15 Full Movie Online Free
Edel Dieringer
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We acknowledge in this episode, as in others, that each of us brings to our work our own unique life experiences. Those lived experiences may shape our responses to other narratives and perspectives. In this episode, between minutes 8:15-11:25, we will grapple with challenging material, including accidents and death, which may for many reasons be difficult to hear, and can manifest in feelings of anxiety and discomfort. If you have difficulty with the material and need additional support, I encourage you to come talk to me or your friends or family. If you are a trauma survivor and encounter a topic in our episodes that is triggering for you, you may feel overwhelmed and find it difficult to concentrate. If those feelings occur, I encourage you to take the necessary steps for your emotional safety. This may include pausing the episode or skipping between minutes 8:15-11:25, while the accident is being described or locating an appropriate professional to help. Please know that the following supports are available at any time.
Thus, there is evidence that psychosis is associated with metabolic alterations independent of common risk factors. However, it is not known if psychosis-associated metabolic alterations manifest as a uniform effect (i.e. mean metabolic levels are increased in patients with similar variability of data around the mean for both patients and controls) or, alternatively, if there is heterogeneity in this effect amongst patients beyond what might be expected due to normal individual differences (i.e. mean metabolic levels are increased in patients but also with increased variability of data in patients compared with controls). We set out to address this question by performing a meta-analysis of variability, as previously employed to examine peripheral immune marker and brain structural variability in first-episode psychosis (FEP) (Brugger & Howes, 2017; Pillinger et al., 2019b). If there is heterogeneity in metabolic alterations amongst patients, e.g. because they are seen only in a subgroup of patients, then there will be greater metabolic variability in patients relative to controls. Conversely, if metabolic alterations are a homogenous component of the pathophysiology of psychosis, reduced or similar metabolic variability in patients compared with controls would be predicted, reflecting homogeneity in pathophysiology.
Background and hypothesis: Insomnia occurs frequently in the clinical course of schizophrenia. A growing literature has found associations between insomnia, suicidal ideation and behavior, and psychopathology in schizophrenia. We explored associations between sleep problems, suicidal ideation, and psychopathology in a cohort of patients with first-episode psychosis.
Study results: The prevalence of sleep problems and suicidal ideation at baseline was 57% and 15%, respectively. After controlling for potential confounders, in the study baseline sleep problems were associated with increased odds of suicidal ideation with evidence of a dose-dependent relationship (OR = 2.25, 95% CI 1.15-4.41, P = .018). Over 24 months, sleep problems at any time point were associated with an over 3-fold increased odds of concurrent suicidal ideation (OR = 3.21, 95% CI 1.45-7.14, P = .004). Subjects with persistent sleep problems were almost 14 times more likely to endorse suicidal ideation at least once over the study than those without sleep problems (OR = 13.8, 95% CI 6.5-53.4, P < .001). Sleep problems were also a predictor of higher Positive and Negative Syndrome Scale total (β = 0.13-0.22), positive (β = 0.14-0.25), and general (β = 0.16-0.27) subscale scores at baseline and multiple follow-up visits (P < .01 for each).
Conclusions: Sleep problems are highly prevalent and associated with suicidal ideation and greater psychopathology in first-episode psychosis. Formal assessment and treatment of insomnia appear relevant to the clinical care of patients with psychosis as a predictor of suicidal ideation and symptom severity.
Plastics are everywhere - in the air we breathe, the water we drink, and even the food we eat. As products that essentially never disappear, plastics have a huge impact on both our environment and our health. In this episode, we talk plastic pollution, regulating waste, and green entrepreneurship with Jay Sinha, Author and Co-founder of Life Without Plastic. He shares with us the ways businesses, government, and even individuals can impact our plastic use, in Canada and abroad.
Jay is an ecopreneur, scientist, lawyer, policy advisor, writer and speaker who hails proudly from the sunny, windy prairies of Winnipeg, Manitoba, Canada. He is the co-founder and co-owner (with business partner Chantal Plamondon) of Life Without Plastic, a globally established online shop and information resource for safe, high quality, ethically-sourced, Earth-friendly alternatives to plastic products for everyday life, including zero waste essentials.
Findings Using a quasi-experimental design in 220 patients with first-episode psychosis, this study found that continued cannabis use after the onset of psychosis was associated with increased risk of relapse of psychosis, resulting in psychiatric hospitalization.
Design, Setting, and Participants This prospective cohort study followed up for at least 2 years after the onset of psychosis 220 patients who presented to psychiatric services in South London, England, from April 12, 2002, to July 26, 2013, with first-episode psychosis. Longitudinal modeling (fixed-effects analysis, cross-lagged path analysis) was used to examine whether the association between changes in cannabis use and risk of relapse over time is the result of shared vulnerability between psychosis and cannabis use, psychosis increasing the risk of cannabis use (reverse causation), or a causal effect of cannabis use on psychosis relapse.
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To the Editor: This is a case report of an elderly man with voltage-gated potassium-channel antibody-associated limbic encephalitis. In this case, he received rituximab and developed a manic episode. It is a reaction we should be aware of when using rituximab.
This was a retrospective cohort study using data from the Hospital Episode Statistics (HES) database (online supplemental box 1) between the financial years 2012/2013 and 2015/2016. Eligible patients were identified in 2012/2013 and those who met the study criteria were then followed for three subsequent years (2013/2014, 2014/2015 and 2015/2016) (figure 1).
Participants were aged 18+ years in 2012/2013 and consisted exclusively of patients with one or more of six comorbidities as denoted by the relevant International Statistical Classification of Diseases and Related Health Problems, Tenth revision (ICD-10) codes (online supplemental table 1) in either the primary or secondary position.8 9 The six comorbidities selected were: bone marrow transplant (BMT), chronic respiratory disease (CRD), diabetes, chronic kidney disease (CKD), chronic heart disease (CHD) and chronic liver disease (CLD). These were chosen because adults with these comorbidities are considered to be at an increased risk of pneumococcal disease.10
None of the participants selected had evidence of a diagnosis of pneumonia (online supplemental table 1) in 2012/2013 and none had died during 2012/2013. The study group were those participants who were subsequently hospitalised with a diagnosis of CAP (based on the relevant ICD-10 codes) in 2013/2014. The comparison group were those participants with no diagnosis of hospitalised CAP in 2013/2014 and who were not hospitalised with CAP at any subsequent point during the study period.
This study illustrates for the first time the increase in the rate of hospital admissions in patients with the six clinical comorbidities included following an episode of hospitalised CAP. This increase was statistically significant in all comorbidity categories apart from post-BMT and was maintained across all three study years. However, there is a lack of precision around point estimates for healthcare resource utilisation for post-BMT patients specifically due to the small number of these participants (n=271). As expected, there was variation between the different comorbidities included, which is consistent with previous findings on the impact of underlying comorbidities and the risk of invasive pneumococcal disease (IPD).19
Our study found that patients with certain underlying comorbidities have a significantly higher likelihood of in-hospital mortality following an episode of hospitalised CAP. The ORs were >4 for all six comorbidities which underlines the importance of measures to prevent episodes of hospitalised pneumonia in patients with comorbidities.
The key findings of this study suggest that following an episode of CAP, adults with underlying comorbidities are subsequently associated with increased healthcare resource utilisation and are at increased risk of mortality for an extended period. An episode of hospitalised CAP is therefore likely to have a prolonged adverse effect on the subsequent health of adults with underlying comorbidities, which supports considering pneumonia as a chronic rather than an acute condition.21 An episode of CAP in adults with underlying comorbidities appears likely to leave them particularly prone to long-term adverse health consequences.22 While this is the first time insights in this context have been obtained using a population of UK adults with underlying comorbidities specifically, similar research undertaken outside the UK has previously highlighted that adults may be left with a compromised health status following an episode of hospitalised CAP. A recent systematic review and meta-analysis reported an increased risk of myocardial infarction, heart failure, dysrhythmias and stroke after CAP, which is maximal in the acute phase but persists long-term after resolution of the pneumonia .23 The finding that there is an increased likelihood of mortality following an episode of hospitalised CAP is reflected by a study in Dutch adults which suggested long-term mortality was higher in those with an underlying comorbidity following an episode of IPD or pneumonia.24 A possible explanation for this is that an episode of hospitalised CAP can compromise the long-term health status of patients with underlying comorbidities.
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