Training probation officers in case formulation for personality disordered offenders.

Background: The UK Strategy on Managing High Risk of Serious Harm Offenders with Severe Personality Disorder proposes an important role for offender managers in completing case formulations about such offenders. There is little evidence on whether this can be achieved.

Aim: Our primary aims were to devise, implement and evaluate training in case formulation for offender managers.

Brain metastases from prostate cancer: an 11-year analysis in the MRI era with emphasis on imaging characteristics, incidence, and prognosis.

Background And Purpose: Brain metastases from prostate cancer are uncommon and their imaging appearance has not been well defined. The main objectives of this study were to evaluate the incidence, MRI characteristics, and prognosis of parenchymal brain metastases originating in prostate cancer.

Methods: We retrospectively identified 21 patients with prostate cancer and evidence of brain metastases from 2000 to 2010.

Mitogen-activated protein kinase-activated protein kinase 2 (MAPKAP-K2) as an antiinflammatory target: discovery and in vivo activity of selective pyrazolo[1,5-a]pyrimidine inhibitors using a focused library and structure-based optimization approach.

A novel class of mitogen-activated protein kinase-activated protein kinase 2 (MAPKAP-K2) inhibitors was discovered through screening a kinase-focused library. A homology model of MAPKAP-K2 was generated and used to guide the initial SAR studies and to rationalize the observed selectivity over CDK2. An X-ray crystal structure of a compound from the active series bound to crystalline MAPKAP-K2 confirmed the predicted binding mode.

Antimicrobial stewardship: a collaborative partnership between infection preventionists and health care epidemiologists.

It is clear that the widespread and injudicious use of antimicrobials has greatly increased the presence of MDROs that threaten the health of all. There is worldwide acknowledgement that this threat is growing, and that prudent use of antimicrobials combined with infection prevention can prevent harm and improve patient safety. Antimicrobial stewardship programs must harness the talents of all members of the health care team to effectively identify the organism, determine its susceptibility, institute any precautions required, and prescribe the narrowest-acting antibiotic that will destroy it.

Assessing the effect of the Surviving Sepsis Campaign treatment guidelines on clinical outcomes in a community hospital.

Background: Bundles yield a reduction in mortality in patients with sepsis, but the majority of the data is from large academic centers. The ability of a community hospital to implement a sepsis bundle successfully, however, has not been investigated.

Objective: To examine the effect of a collaborative 2-part sepsis bundle on clinical outcomes and mortality at a community hospital.

An empirical evaluation of reasons for non-completion of treatment in a dangerous and severe personality disorder unit.

Background: Individuals deemed to be of high risk to others, and diagnosed with severe personality disorders have become the focus for developing clinical services in England. Such services often require highly secure accommodation and labour-intensive therapeutic interventions. There is, however, uncertainty about the capacity to engage such patients effectively in therapies.

Sliding scale versus tight glycemic control in the noncritically ill at a community hospital.

Background: Development of hyperglycemia during hospitalization is an area of concern in patients with and without diabetes mellitus. Tight glycemic control has been debated for critically ill and noncritically ill patients with hyperglycemia. Although many studies have been performed in the critically ill, adequate data are not available in the noncritically ill population.

Outcomes of extended infusion piperacillin/tazobactam for documented Gram-negative infections.

This comparison of intermittent versus extended-infusion piperacillin-tazobactam among patients with Gram-negative infections revealed similar mortality and length of stay. Outcomes remained similar when stratified by MIC value.

Clinical outcomes and cost minimization with an alternative dosing regimen for meropenem in a community hospital.

Study Objective: To compare outcomes and cost for the traditional United States Food and Drug Administration-approved dosing regimen for meropenem versus an alternative dosing regimen providing similar pharmacodynamic exposure with a lower total daily dose.

Design: Retrospective cohort study with a cost-minimization analysis.

Setting: A 417-bed, privately owned community hospital.

The role of second autografts in the management of myeloma at first relapse.

We report an analysis of the value of a second high-dose melphalan autograft, performed at relapse, on a series of newly diagnosed myeloma patients entered into the high-dose program at our center. We conclude that relapse-free survival after the first autograft is a major prognostic factor in determining outcome.

Long-term outcomes of previously untreated myeloma patients: responses to induction chemotherapy and high-dose melphalan incorporated within a risk stratification model can help to direct the use of novel treatments.

Induction chemotherapy followed by high-dose melphalan (HDM) is the standard treatment for fitter patients with myeloma. The place of bortezomib and the thalidomide analogues within this treatment paradigm is yet to be established. We sought to identify patients who may benefit from the introduction of novel agents during their initial management.