Sample records for dually diagnosed individuals
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Dually diagnosed patients' benefits of mutual-help groups and the role of social anxiety.
Timko, Christine; Cronkite, Ruth C; McKellar, John; Zemore, Sarah; Moos, Rudolf H
2013-02-01
There is debate about whether dually diagnosed patients benefit from mutual-help groups (MHGs), partly because social anxiety may make participation problematic. We examined dually diagnosed patients' participation in MHGs and outcomes at 6, 12, and 24 months post-treatment, and the extent to which social anxiety was associated with participation. We also examined whether MHG participation and social anxiety were related to outcomes, and whether social anxiety moderated associations between participation and outcomes. We found high rates of MHG participation. Among patients who attended at least one meeting, outcomes were positive. Social anxiety was not associated with levels of MHG participation, but more participation was associated with better outcomes. When social anxiety moderated associations between MHG participation and outcomes, patients with more social anxiety benefited more from participation. Treated dually diagnosed patients participate in, and benefit from, MHGs, and participation and benefits are comparable, or even strengthened, among more socially-anxious patients. Published by Elsevier Inc.
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Quality of life among dually diagnosed and non-substance-using ...
African Journals Online (AJOL)
Objective. To assess the quality of life (QoL) in an outpatient setting among male patients dually diagnosed with schizophrenia and substance use disorder (SUD), and non-substance-using male schizophrenia patients. Methods. The study was conducted in an outpatient setting with 52 male schizophrenia patients and 49 ...
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Teaching self-control to small groups of dually diagnosed adults.
Dixon, M R; Holcomb, S
2000-01-01
The present study examined the use of a progressive delay procedure to teach self-control to two groups of dually diagnosed adults. When given a choice between an immediate smaller reinforcer and a larger delayed reinforcer, both groups chose the smaller reinforcer during baseline. During treatment, progressive increases in work requirements for gaining access to a larger reinforcer resulted in both groups selecting larger delayed reinforcers. The results are discussed with respect to increas...
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Coker, Kendell L; Stefanovics, Elina; Rosenheck, Robert
2016-01-01
Substantial rates of substance use comorbidity have been observed among veterans with Post-Traumatic Stress Disorder (PTSD), highlighting the need to identify patient and program characteristics associated with improved outcomes for substance abuse. Data were drawn from 12,270 dually diagnosed veterans who sought treatment from specialized intensive Veterans Health Administration PTSD programs between 1993 and 2011. The magnitude of the improvement in Addiction Severity Index (ASI) alcohol and drug use composite scores from baseline was moderate, with effect sizes (ES) of -.269 and -.287, respectively. Multivariate analyses revealed that treatment in longer-term programs, being prescribed psychiatric medication, and planned participation in reunions were all associated with slightly improved outcomes. Reductions in substance use measures were associated with robust improvements in PTSD symptoms and violent behavior. These findings suggest not only synergistic treatment effects linking improvement in PTSD symptoms with substance use disorders among dually diagnosed veterans with PTSD, but also to reductions in violent behavior. Furthermore, the findings indicate that proper discharge planning in addition to intensity and duration of treatment for dually diagnosed veterans with severe PTSD may result in better outcomes. Further dissemination of evidence-based substance abuse treatment may benefit this population. (c) 2016 APA, all rights reserved).
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Schnell, Thomas; Koethe, Dagmar; Krasnianski, Anna; Gairing, Stefanie; Schnell, Knut; Daumann, Jörg; Gouzoulis-Mayfrank, Euphrosyne
2014-01-01
Clozapine is considered to be particularly effective in the treatment of dually diagnosed (DD) patients with psychosis and substance use disorders. However, its use is restricted by potentially severe side effects. The aim of the present pilot study was to compare the effects of clozapine with the newer second generation antipsychotic (SGA) ziprasidone in DD-patients. Thirty (n = 30) patients with schizophrenia and cannabis abuse/dependence were randomized to ziprasidone or clozapine and were followed up for up to 12 months. Cannabis use was reduced in both groups during follow-up. Clozapine treatment was associated with less positive symptoms of schizophrenia, more side effects and poorer compliance with treatment. Results from this small pilot RCT suggest beneficial effects of both clozapine and ziprasidone in the treatment of cannabis use disorders in psychotic patients. Larger-scale RCTs are needed in order to assess advantages and disadvantages of the different SGAs in dually diagnosed populations. © American Academy of Addiction Psychiatry.
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Buckner, Julia D; Walukevich, Katherine A; Zvolensky, Michael J; Gallagher, Matthew W
2017-11-01
Little empirical work has evaluated why anxious cannabis users are especially vulnerable to poorer cannabis cessation outcomes. Presumably, these individuals rely on cannabis because they have difficulties with emotion regulation and they therefore use cannabis to manage their negative emotions. The current study examined the direct and indirect effects of anxiety severity on a range of cannabis cessation variables among 79 (63.3% non-Hispanic White; 43.0% female) adults with anxiety disorders seeking outpatient treatment for cannabis use disorder. The independent and serial indirect effects of difficulties with emotion regulation and coping motives were examined in relation to the anxiety-cannabis variables. Anxiety severity was directly and robustly related to greater cannabis withdrawal symptom severity, less self-efficacy to refrain from using cannabis in emotionally distressing situations, and more reasons for quitting. Anxiety was indirectly related to cannabis outcomes via the serial effects of emotion regulation and coping motives. These findings document the important role of emotion regulation and coping motives in the relations of anxiety with cannabis cessation variables among dually diagnosed outpatients. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
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Quality of life among dually diagnosed and non-substance-using male schizophrenia outpatients
Directory of Open Access Journals (Sweden)
Hatice Imer Aras
2013-06-01
Full Text Available Objective. To assess the quality of life (QoL in an outpatient setting among male patients dually diagnosed with schizophrenia and substance use disorder (SUD, and non-substance-using male schizophrenia patients. Methods. The study was conducted in an outpatient setting with 52 male schizophrenia patients and 49 male schizophrenia patients with SUD comorbidity, who were admitted to Bakirköy Research and Training Hospital between 1 May 2010 and 30 September 2010. The patients had been in remission for a minimum of 6 months. The subjects were re-evaluated for the persistence of the diagnosis by using the Structural Clinical Interview for DSM-IV Axis I disorders (SCID I socio-demographic data form, and the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF and positive and negative syndrome scale (PANSS were administered to detect the factors affecting diagnostic stability and clinical course. Results. Schizophrenia patients with no SUD comorbidity had a significantly earlier age of disease onset than the comorbid group. SUD comorbidity in schizophrenia patients leads to increased rates of unemployment and homicidality. WHOQOL-Bref psychological health scores were significantly lower among patients in the comorbidity group. No statistically significant difference was identified between the groups with regard to the PANSS scores. Conclusions. It is necessary to focus on the treatment challenges for schizophrenia patients with SUD comorbidity, such as the provision of treatment in criminal justice settings, in which a high proportion of such patients are found.
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Bouis, Stephanie; Reif, Susan; Whetten, Kathryn; Scovil, Janet; Murray, Andrea; Swartz, Marvin
2007-01-01
The challenge of providing effective treatment services for the growing population of HIV-positive individuals who are also dually diagnosed with substance use and mental disorders has only recently been recognized as an important public health concern affecting both HIV treatment and prevention. This article describes a treatment model that was…
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Brown, Julie F.; Hamilton-Mason, Johnnie; Maramaldi, Peter; Barnhill, L. Jarrett
2016-01-01
The perspectives of individuals with intellectual disabilities (ID) about family relationships are underrepresented in the literature. The topic of family relationships emerged in a grounded theory exploratory focus group study that involved thirty dually diagnosed participants with moderate or mild intellectual disabilities and histories of…
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Zheng, Nan Tracy; Haber, Susan; Hoover, Sonja; Feng, Zhanlian
2017-12-01
Medicaid programs are not required to pay the full Medicare coinsurance and deductibles for Medicare-Medicaid dually eligible beneficiaries. We examined the association between the percentage of Medicare cost sharing paid by Medicaid and the likelihood that a dually eligible beneficiary used evaluation and management (E&M) services and safety net provider services. Medicare and Medicaid Analytic eXtract enrollment and claims data for 2009. Multivariate analyses used fee-for-service dually eligible and Medicare-only beneficiaries in 20 states. A comparison group of Medicare-only beneficiaries controlled for state factors that might influence utilization. Paying 100 percent of the Medicare cost sharing compared to 20 percent increased the likelihood (relative to Medicare-only) that a dually eligible beneficiary had any E&M visit by 6.4 percent. This difference in the percentage of cost sharing paid decreased the likelihood of using safety net providers, by 37.7 percent for federally qualified health centers and rural health centers, and by 19.8 percent for hospital outpatient departments. Reimbursing the full Medicare cost-sharing amount would improve access for dually eligible beneficiaries, although the magnitude of the effect will vary by state and type of service. © Health Research and Educational Trust.
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Directory of Open Access Journals (Sweden)
Shun-ichi Amari
2014-04-01
Full Text Available Information geometry studies the dually flat structure of a manifold, highlighted by the generalized Pythagorean theorem. The present paper studies a class of Bregman divergences called the (ρ,τ-divergence. A (ρ,τ -divergence generates a dually flat structure in the manifold of positive measures, as well as in the manifold of positive-definite matrices. The class is composed of decomposable divergences, which are written as a sum of componentwise divergences. Conversely, a decomposable dually flat divergence is shown to be a (ρ,τ -divergence. A (ρ,τ -divergence is determined from two monotone scalar functions, ρ and τ. The class includes the KL-divergence, α-, β- and (α, β-divergences as special cases. The transformation between an affine parameter and its dual is easily calculated in the case of a decomposable divergence. Therefore, such a divergence is useful for obtaining the center for a cluster of points, which will be applied to classification and information retrieval in vision. For the manifold of positive-definite matrices, in addition to the dually flatness and decomposability, we require the invariance under linear transformations, in particular under orthogonal transformations. This opens a way to define a new class of divergences, called the (ρ,τ -structure in the manifold of positive-definite matrices.
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Seo, Hwi Won; Park, Su-Jin; Park, Changhoon; Chae, Chanhee
2014-05-01
The objective of this study was to determine the effects of porcine circovirus type 2 (PCV2) and Mycoplasma hyopneumoniae vaccinations on disease severity in an experimental PCV2-M. hyopneumoniae dual challenge model. Vaccine effectiveness was evaluated using microbiological (PCV2 viremia and M. hyopneumoniae nasal shedding), immunological (neutralizing antibodies and interferon-γ-secreting cells), and pathological (gross lung lesions, histopathologic pulmonary and lymphoid lesions, and the presence of PCV2 antigen and M. hyopneumoniae DNA within the lesions) evaluations. Although M. hyopneumoniae potentiates the severity of PCV2-associated lesions and lesion-associated PCV2 antigen in dually challenged pigs, vaccination against M. hyopneumoniae alone did not reduce PCV2 viremia, PCV2-induced lesions, or PCV2 antigen in dually challenged pigs. In addition, vaccination against PCV2 did not reduce the nasal shedding of M. hyopneumoniae, the M. hyopneumoniae-induced pulmonary lesions or the lesion-associated M. hyopneumoniae DNA in dually challenged pigs. Dual challenge with PCV2 and M. hyopneumoniae did not interfere with the induction of active immunity induced by a previous single vaccination for either PCV2 or M. hyopneumoniae. The results of this study demonstrated that (i) vaccination against M. hyopneumoniae alone did not decrease the potentiation of PCV2-induced lesions by M. hyopneumoniae and (ii) vaccination against PCV2 alone decreased the potentiation of PCV2-induced lesions by M. hyopneumoniae in dually challenged pigs. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Kalichman, Seth C.; Pellowski, Jennifer; Kegler, Christopher; Cherry, Chauncey; Kalichman, Moira O.
2015-01-01
Beliefs about medication necessity and concerns predict treatment adherence in people with a wide-array of medical conditions, including HIV infection. However, medication beliefs have not been examined in people dually treated with psychotropic medications and antiretroviral therapy. In the current study, we used a prospective design to investigate the factors associated with adherence to psychotropic medications and antiretrovirals among 123 dually treated persons living with HIV. We used u...
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Korean sibling caregivers of individuals diagnosed with schizophrenia
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Mijung Park
2017-12-01
Full Text Available Siblings of individuals diagnosed with schizophrenia are an important source of family caregiving. Unfortunately, limited information is available about sibling caregivers because existing studies have focused on other family relationships such as parents, spouses, and children. To fill the knowledge gap, the purpose of this study is to describe Korean sibling caregivers’ experience with individuals diagnosed with schizophrenia. Guided by Colaizzi’s descriptive phenomenological methodology, we conducted in-depth, semi-structured, face-to-face interviews with eight individuals who have a sibling (1 diagnosed with schizophrenia and (2 hospitalized in an inpatient psychiatric unit. We discerned six key themes: sorrow, burnout, shame, different perspectives in life, acceptance, and responsibility. We categorized these themes into three groups: suffering, hope, and responsibility and obligation. Sibling caregivers of individuals with schizophrenia experience a mixture of several emotions. Participants loved their brother or sister with schizophrenia, but at the same time they felt shame and fear. While they were burdened by the responsibilities of caregiving, they remained loyal to their sibling with schizophrenia, continuing to help their siblings reach their full potential. Although participants were confused about the symptoms of schizophrenia, they were committed to learning more about the illness. Because we conducted the current study in Korea, the findings of this study may be unique to Korea culture. Further studies are needed to compare and contrast nuanced differences in sibling caregivers’ experience among different cultural groups.
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Shashi, Vandana; Schoch, Kelly; Spillmann, Rebecca; Cope, Heidi; Tan, Queenie K-G; Walley, Nicole; Pena, Loren; McConkie-Rosell, Allyn; Jiang, Yong-Hui; Stong, Nicholas; Need, Anna C; Goldstein, David B
2018-06-15
Sixty to seventy-five percent of individuals with rare and undiagnosed phenotypes remain undiagnosed after exome sequencing (ES). With standard ES reanalysis resolving 10-15% of the ES negatives, further approaches are necessary to maximize diagnoses in these individuals. In 38 ES negative patients an individualized genomic-phenotypic approach was employed utilizing (1) phenotyping; (2) reanalyses of FASTQ files, with innovative bioinformatics; (3) targeted molecular testing; (4) genome sequencing (GS); and (5) conferring of clinical diagnoses when pathognomonic clinical findings occurred. Certain and highly likely diagnoses were made in 18/38 (47%) individuals, including identifying two new developmental disorders. The majority of diagnoses (>70%) were due to our bioinformatics, phenotyping, and targeted testing identifying variants that were undetected or not prioritized on prior ES. GS diagnosed 3/18 individuals with structural variants not amenable to ES. Additionally, tentative diagnoses were made in 3 (8%), and in 5 individuals (13%) candidate genes were identified. Overall, diagnoses/potential leads were identified in 26/38 (68%). Our comprehensive approach to ES negatives maximizes the ES and clinical data for both diagnoses and candidate gene identification, without GS in the majority. This iterative approach is cost-effective and is pertinent to the current conundrum of ES negatives.
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Death Concerns among Individuals Newly Diagnosed with Lung Cancer
Lehto, Rebecca; Therrien, Barbara
2010-01-01
Confronting the reality of death is an important challenge for individuals facing life-threatening illness such as lung cancer, the leading cause of cancer death. Few studies, however, document the nature of death-related concerns in individuals newly diagnosed with lung cancer. The aims of this exploratory study were to examine unsolicited…
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Diagnosing phenotypes of single-sample individuals by edge biomarkers.
Zhang, Wanwei; Zeng, Tao; Liu, Xiaoping; Chen, Luonan
2015-06-01
Network or edge biomarkers are a reliable form to characterize phenotypes or diseases. However, obtaining edges or correlations between molecules for an individual requires measurement of multiple samples of that individual, which are generally unavailable in clinical practice. Thus, it is strongly demanded to diagnose a disease by edge or network biomarkers in one-sample-for-one-individual context. Here, we developed a new computational framework, EdgeBiomarker, to integrate edge and node biomarkers to diagnose phenotype of each single test sample. By applying the method to datasets of lung and breast cancer, it reveals new marker genes/gene-pairs and related sub-networks for distinguishing earlier and advanced cancer stages. Our method shows advantages over traditional methods: (i) edge biomarkers extracted from non-differentially expressed genes achieve better cross-validation accuracy of diagnosis than molecule or node biomarkers from differentially expressed genes, suggesting that certain pathogenic information is only present at the level of network and under-estimated by traditional methods; (ii) edge biomarkers categorize patients into low/high survival rate in a more reliable manner; (iii) edge biomarkers are significantly enriched in relevant biological functions or pathways, implying that the association changes in a network, rather than expression changes in individual molecules, tend to be causally related to cancer development. The new framework of edge biomarkers paves the way for diagnosing diseases and analyzing their molecular mechanisms by edges or networks in one-sample-for-one-individual basis. This also provides a powerful tool for precision medicine or big-data medicine. © The Author (2015). Published by Oxford University Press on behalf of Journal of Molecular Cell Biology, IBCB, SIBS, CAS. All rights reserved.
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Equivalent model of a dually-fed machine for electric drive control systems
Ostrovlyanchik, I. Yu; Popolzin, I. Yu
2018-05-01
The article shows that the mathematical model of a dually-fed machine is complicated because of the presence of a controlled voltage source in the rotor circuit. As a method of obtaining a mathematical model, the method of a generalized two-phase electric machine is applied and a rotating orthogonal coordinate system is chosen that is associated with the representing vector of a stator current. In the chosen coordinate system in the operator form the differential equations of electric equilibrium for the windings of the generalized machine (the Kirchhoff equation) are written together with the expression for the moment, which determines the electromechanical energy transformation in the machine. Equations are transformed so that they connect the currents of the windings, that determine the moment of the machine, and the voltages on these windings. The structural diagram of the machine is assigned to the written equations. Based on the written equations and accepted assumptions, expressions were obtained for the balancing the EMF of windings, and on the basis of these expressions an equivalent mathematical model of a dually-fed machine is proposed, convenient for use in electric drive control systems.
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Sociodemographic Study of Danish Individuals Diagnosed with Transsexualism
Directory of Open Access Journals (Sweden)
Rikke Simonsen, MA
2015-06-01
Conclusions: As approximately half of MtF started cross-sex hormonal SR without attending a gender unit, future treatment needs to focus on this group of MtF individuals in order to accommodate the medical risks of self-initiated hormonal treatment.Earlier intervention with adolescents appears necessary since three-quarters of FtM individuals before age 12 had problems with their assigned sex. For both MtF and FtM, we found problems in areas of school, education, and employment and recommend further help in these core areas. Simonsen R, Hald GM, Giraldi A, and Kristensen E. Sociodemographic study of danish individuals diagnosed with transsexualism. Sex Med 2015;3:109–117.
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Zero Cross-Talk Regimes in Dually Modulated Mutually-Coupled Nano-lasers
International Nuclear Information System (INIS)
Han, H; Zhang, M J; Wang, Y C; Shore, K A
2017-01-01
The modulation properties of dually modulated mutually-coupled nano-lasers have been analyzed using rate equations which include the Purcell cavity-enhanced spontaneous emission factor F and the spontaneous emission coupling factor β . Analysis of the dynamical response of modulated mutually-coupled nano-lasers reveals the existence of regimes of zero cross-talk wherein the response of one nano-laser is not impacted by the dynamics of the other nano-laser. The availability of zero-cross talk regimes is seen to offer opportunities for exploitation in photonic integrated circuits. (paper)
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The Emotional Lexicon of Individuals Diagnosed with Antisocial Personality Disorder
Gawda, Barbara
2013-01-01
This study investigated the specific emotional lexicons in narratives created by persons diagnosed with antisocial personality disorder (ASPD) to test the hypothesis that individuals with ASPD exhibit deficiencies in emotional language. Study participants consisted of 60 prison inmates with ASPD, 40 prison inmates without ASPD, and 60 men without…
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Tchounga, Boris K; Inwoley, Andre; Coffie, Patrick A; Minta, Daouda; Messou, Eugene; Bado, Guillaume; Minga, Albert; Hawerlander, Denise; Kane, Coumba; Eholie, Serge P; Dabis, François; Ekouevi, Didier K
2014-01-01
Introduction West Africa is characterized by the circulation of HIV-1 and HIV-2. The laboratory diagnosis of these two infections as well as the choice of a first-line antiretroviral therapy (ART) is challenging, considering the limited access to second-line regimens. This study aimed at confirming the classification of HIV-2 and HIV-1&2 dually reactive patients followed up in the HIV-2 cohort of the West African Database to evaluate AIDS collaboration. Method A cross-sectional survey was conducted from March to December 2012 in Burkina Faso, Côte d’Ivoire and Mali among patients classified as HIV-2 or HIV-1&2 dually reactive according to the national HIV testing algorithms. A 5-ml blood sample was collected from each patient and tested in a single reference laboratory in Côte d’Ivoire (CeDReS, Abidjan) with two immuno-enzymatic tests: ImmunoCombII® (HIV-1&2 ImmunoComb BiSpot – Alere) and an in-house ELISA test, approved by the French National AIDS and hepatitis Research Agency (ANRS). Results A total of 547 patients were included; 57% of them were initially classified as HIV-2 and 43% as HIV-1&2 dually reactive. Half of the patients had CD4≥500 cells/mm3 and 68.6% were on ART. Of the 312 patients initially classified as HIV-2, 267 (85.7%) were confirmed as HIV-2 with ImmunoCombII® and in-house ELISA while 16 (5.1%) and 9 (2.9%) were reclassified as HIV-1 and HIV-1&2, respectively (Kappa=0.69; p<0.001). Among the 235 patients initially classified as HIV-1&2 dually reactive, only 54 (23.0%) were confirmed as dually reactive with ImmunoCombII® and in-house ELISA, while 103 (43.8%) and 33 (14.0%) were reclassified as HIV-1 and HIV-2 mono-infected, respectively (kappa= 0.70; p<0.001). Overall, 300 samples (54.8%) were concordantly classified as HIV-2, 63 (11.5%) as HIV-1&2 dually reactive and 119 (21.8%) as HIV-1 (kappa=0.79; p<0.001). The two tests gave discordant results for 65 samples (11.9%). Conclusions Patients with HIV-2 mono-infection are correctly
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Fletcher, Robert J.; Barnhill, Jarrett; McCarthy, Jane; Strydom, André
2016-01-01
Recognizing the diagnostic challenges that clinicians face when attempting to arrive at an accurate psychiatric diagnosis for individuals with intellectual and developmental disabilities (IDD) co-occurring with mental illness (MI), in 2007 the National Association for the Dually Diagnosed (NADD), in association with the American Psychiatric…
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International Nuclear Information System (INIS)
Lokitz, Bradley S.; Wei, Jifeng; Hinestrosa Salazar, Juan P.; Ivanov, Ilia N.; Browning, James B.; Ankner, John Francis; Kilbey, S. Michael II; Messman, Jamie M.
2012-01-01
The assembly of dually reactive, well-defined diblock copolymers incorporating the chemoselective/functional monomer, 4,4-dimethyl-2-vinylazlactone (VDMA) and the surface-reactive monomer glycidyl methacrylate (GMA) is examined to understand how competition between surface attachment and microphase segregation influences interfacial structure. Reaction of the PGMA block with surface hydroxyl groups not only anchors the copolymer to the surface, but limits chain mobility, creating brush-like structures comprising PVDMA blocks, which contain reactive azlactone groups. The block copolymers are spin coated at various solution concentrations and annealed at elevated temperature to optimize film deposition to achieve a molecularly uniform layer. The thickness and structure of the polymer thin films are investigated by ellipsometry, infrared spectroscopy, and neutron reflectometry. The results show that deposition of PGMA-b-PVDMA provides a useful route to control film thickness while preserving azlactone groups that can be further modified with biotin-poly(ethylene glycol)amine to generate designer surfaces. The method described herein offers guidance for creating highly functional surfaces, films, or coatings through the use of dually reactive block copolymers and postpolymerization modification.
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Comparing risk profiles of individuals diagnosed with diabetes by OGTT and HbA1c
DEFF Research Database (Denmark)
Borg, R.; Vistisen, D.; Witte, D.R.
2010-01-01
Glycated haemoglobin (HbA(1c)) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods.......Glycated haemoglobin (HbA(1c)) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods....
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Park, Su-Jin; Seo, Hwi Won; Park, Changhoon; Chae, Chanhee
2014-06-01
The objective of this study was to determine the effects of Mycoplasma hyopneumoniae and/or porcine reproductive and respiratory syndrome virus (PRRSV) vaccination on dually infected pigs. In total, 72 pigs were randomly divided into nine groups (eight pigs per group), as follows: five vaccinated and challenged groups, three non-vaccinated and challenged groups, and a negative control group. Single-dose vaccination against M. hyopneumoniae alone decreased the levels of PRRSV viremia and PRRSV-induced pulmonary lesions, whereas single-dose vaccination against PRRSV alone did not decrease nasal shedding of M. hyopneumoniae and mycoplasma-induced pulmonary lesions in the dually infected pigs. The M. hyopneumoniae challenge impaired the protective cell-mediated immunity induced by the PRRSV vaccine, whereas the PRRSV challenge did not impair the protective cell-mediated immunity induced by the M. hyopneumoniae vaccine. The present study provides swine practitioners and producers with efficient vaccination regimes; vaccination against M. hyopneumoniae is the first step in protecting pigs against co-infection with M. hyopneumoniae and PRRSV. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Newest Web-Technologies for Studying and Diagnosing Individual Abilities of Learners
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Yuliya S. Nikolaeva
2017-09-01
Full Text Available The relevance of the research is due to the need of taking into account the learners' cognitive characteristics in the educational process. Knowing the personal qualities of people is also important when choosing an occupation or employment. This is why the paper is aimed at describing the opportunities of the newest Web and mobile applications for studies and self-diagnostics of users based on the cloud technology of diagnosing the human individual and cognitive abilities. The leading approach to studying this problem is the projective and recursive strategy that allows viewing the problem of expert statistics accumulation and user diagnostic results analysis in an integrated way. The paper presents the developments in problem-solving computer environments for diagnosing human individual and integrated abilities. Grounds are given for diagnostics of the main human cognitive abilities: the scope of memory and attention; information processing, reading, typing speeds and others. The website for developing the new diagnostics and conducting studies can be accessed by everyone with any browser via http://self-test.ufoproger.ru. The website has been developed by the university students under the guidance of professor N.I. Pak. The materials of the paper are of practical value for teachers designing the educational process up to the learners' individual characteristics.
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DEFF Research Database (Denmark)
Han, Li; Le, Thanh Hung; Van Nong, Ngo
2012-01-01
Al, Ga dually-doped ZnO was prepared by spark plasma sintering with different sintering temperatures. The microstructural evolution and thermoelectric properties of the samples were investigated in detail. The samples with a sintering temperature above 1223K obtained higher relative densities...
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Utility of Formal Preference Assessments for Individuals Diagnosed with Autism Spectrum Disorder
Leaf, Justin B.; Leaf, Ronald; Alcalay, Aditt; Leaf, Jeremy A.; Ravid, Daniel; Dale, Stephanie; Kassardjian, Alyne; Tsuji, Kathleen; Taubman, Mitchell; McEachin, John; Oppenheim-Leaf, Misty
2015-01-01
The systematic use of reinforcers is an essential component of behavioral intervention for individuals diagnosed with Autism Spectrum Disorder. Today, the use of rigorous formal preference assessments, including paired-preference assessments, are widely conducted to help determine which items to use as reinforcers during intervention. Although…
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Directory of Open Access Journals (Sweden)
Xinjun Li
2014-08-01
Full Text Available Objectives: To examine whether there is an association between neighbourhood deprivation and diagnosed childhood obesity, after accounting for family- and individual-level socio-demographic characteristics. Methods: An open cohort of all children aged 0-14 years was followed between January 1, 2000 and December 31, 2010. Childhood residential locations were geocoded and classified according to neighbourhood deprivation. Data were analysed by multilevel logistic regression, with family- and individual-level characteristics at the first level and level of neighbourhood deprivation at the second level. Results: During the study period, among a total of 948,062 children, 10,799 were diagnosed with childhood obesity. Age-adjusted cumulative incidence for diagnosed childhood obesity increased with increasing level of neighbourhood deprivation. Incidence of diagnosed childhood obesity increased with increasing neighbourhood-level deprivation across all family and individual-level socio-demographic categories. The odds ratio (OR for diagnosed childhood obesity for those living in high-deprivation neighbourhoods versus those living in low-deprivation neighbourhoods was 2.44 (95% confidence interval (CI = 2.22-2.68. High neighbourhood deprivation remained significantly associated with higher odds of diagnosed childhood obesity after adjustment for family- and individual-level socio-demographic characteristics (OR = 1.70, 95% CI = 1.55-1.89. Age, middle level family income, maternal marital status, low level education, living in large cities, advanced paternal and maternal age, family history of obesity, parental history of diabetes, chronic obstructive pulmonary disease, alcoholism and personal history of diabetes were all associated with higher odds of diagnosed childhood obesity. Conclusions: Our results suggest that neighbourhood characteristics affect the odds of diagnosed childhood obesity independently of family- and individual-level socio
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Sibling sex ratio of individuals diagnosed with autism spectrum disorder as children
DEFF Research Database (Denmark)
Mouridsen, Svend Erik; Rich, Bente; Isager, Torben
2010-01-01
AIM: To study the sex ratio (proportion of males) in siblings of individuals diagnosed with autism spectrum disorders (ASDs) as children. METHOD: In the current study, we extended previous studies dealing with the androgen theory of autism and examined sex ratios in the siblings of 326 individuals...... the Danish live-birth sex ratio over the same period (0.514, p=0.001). The sibling sex ratio was not associated with the IQ in the autistic probands. INTERPRETATION: Our findings suggest a potential indirect confirmation of the androgen theory of autism....
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Energy Technology Data Exchange (ETDEWEB)
Luo, Chunhong; Xu, Guoguang; Wang, Xinghui [Department of Materials Science and Engineering, College of Science and Engineering, Jinan University, Guangzhou 510632 (China); Tu, Mei; Zeng, Rong; Rong, Jianhua [Department of Materials Science and Engineering, College of Science and Engineering, Jinan University, Guangzhou 510632 (China); Engineering Research Center of Artificial Organs and Materials, Ministry of Education, Guangzhou 510632 (China); Zhao, Jianhao, E-mail: jhzhao@jnu.edu.cn [Department of Materials Science and Engineering, College of Science and Engineering, Jinan University, Guangzhou 510632 (China); Engineering Research Center of Artificial Organs and Materials, Ministry of Education, Guangzhou 510632 (China)
2015-01-01
A series of self-reinforcing hyaluronan hydrogels were developed to improve mechanical properties and protein sustained delivery thanks to a dually cross-linked network. Hyaluronan gel particles (HGPs, 1–5 μm in diameter) with different cross-linking densities, i.e. HGPs-1.5, HGPs-3 and HGPs-15, were prepared in an inverse emulsion system and used as the reinforcing phase after glycidyl methacrylation, while glycidyl methacrylated hyaluronan with a substitution degree of 45.2% was synthesized as the matrix phase. These two phases were cross-linked under ultraviolet irradiation to form self-reinforcing hyaluronan hydrogels (srHAs) that showed typical cross-linked structure of HGPs connecting the matrix phase by cross-section observation. In comparison to hyaluronan bulk gels and their blends with HGPs, srHAs distinctly enhanced the mechanical properties and BSA long-term sustained delivery, especially srHA-1.5 showed the highest compressive modulus of 220 ± 15 kPa and the slowest BSA delivery (67% release at 14 d). The 3T3 fibroblast cell culture showed that all the srHAs had no cytotoxicity. - Highlights: • New self-reinforcing HA hydrogels with a dually cross-linked network were developed. • Self-reinforcing HA hydrogels greatly enhanced the mechanical properties. • Self-reinforcing HA hydrogels prolonged the sustained delivery of BSA. • The self-reinforcing mechanism and BSA diffusion mechanism were discussed. • Self-reinforcing HA hydrogels had no cytotoxicity to 3T3 fibroblast cells.
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International Nuclear Information System (INIS)
Luo, Chunhong; Xu, Guoguang; Wang, Xinghui; Tu, Mei; Zeng, Rong; Rong, Jianhua; Zhao, Jianhao
2015-01-01
A series of self-reinforcing hyaluronan hydrogels were developed to improve mechanical properties and protein sustained delivery thanks to a dually cross-linked network. Hyaluronan gel particles (HGPs, 1–5 μm in diameter) with different cross-linking densities, i.e. HGPs-1.5, HGPs-3 and HGPs-15, were prepared in an inverse emulsion system and used as the reinforcing phase after glycidyl methacrylation, while glycidyl methacrylated hyaluronan with a substitution degree of 45.2% was synthesized as the matrix phase. These two phases were cross-linked under ultraviolet irradiation to form self-reinforcing hyaluronan hydrogels (srHAs) that showed typical cross-linked structure of HGPs connecting the matrix phase by cross-section observation. In comparison to hyaluronan bulk gels and their blends with HGPs, srHAs distinctly enhanced the mechanical properties and BSA long-term sustained delivery, especially srHA-1.5 showed the highest compressive modulus of 220 ± 15 kPa and the slowest BSA delivery (67% release at 14 d). The 3T3 fibroblast cell culture showed that all the srHAs had no cytotoxicity. - Highlights: • New self-reinforcing HA hydrogels with a dually cross-linked network were developed. • Self-reinforcing HA hydrogels greatly enhanced the mechanical properties. • Self-reinforcing HA hydrogels prolonged the sustained delivery of BSA. • The self-reinforcing mechanism and BSA diffusion mechanism were discussed. • Self-reinforcing HA hydrogels had no cytotoxicity to 3T3 fibroblast cells
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Ekouevi, Didier K; Balestre, Eric; Coffie, Patrick A; Minta, Daouda; Messou, Eugene; Sawadogo, Adrien; Minga, Albert; Sow, Papa Salif; Bissagnene, Emmanuel; Eholie, Serge P; Gottlieb, Geoffrey S; Dabis, François; Zannou, Djimon Marcel; Ahouada, Carin; Akakpo, Jocelyn; Ahomadegbé, Christelle; Bashi, Jules; Gougounon-Houéto, Alice; Azon-Kouanou, Angèle; Houngbé, Fabien; Koumakpaï, Sikiratou; Alihonou, Florence; d'Almeida, Marcelline; Hodonou, Irvine; Hounhoui, Ghislaine; Sagbo, Gracien; Tossa-Bagnan, Leïla; Adjide, Herman; Drabo, Joseph; Bognounou, René; Dienderé, Arnaud; Traore, Eliezer; Zoungrana, Lassane; Zerbo, Béatrice; Sawadogo, Adrien Bruno; Zoungrana, Jacques; Héma, Arsène; Soré, Ibrahim; Bado, Guillaume; Tapsoba, Achille; Yé, Diarra; Kouéta, Fla; Ouedraogo, Sylvie; Ouédraogo, Rasmata; Hiembo, William; Gansonré, Mady; Messou, Eugène; Gnokoro, Joachim Charles; Koné, Mamadou; Kouakou, Guillaume Martial; Bosse, Clarisse Amani; Brou, Kouakou; Assi, Achi Isidore; Chenal, Henri; Hawerlander, Denise; Soppi, Franck; Minga, Albert; Abo, Yao; Bomisso, Germain; Eholié, Serge Paul; Amego, Mensah Deborah Noelly; Andavi, Viviane; Diallo, Zelica; Ello, Frédéric; Tanon, Aristophane Koffi; Koule, Serge Olivier; Anzan, Koffi Charles; Guehi, Calixte; Aka, Edmond Addi; Issouf, Koffi Ladji; Kouakou, Jean-Claude; N'gbeche, Marie-Sylvie; Touré, Pety; Avit-Edi, Divine; Kouakou, Kouadio; Moh, Magloire; Yao, Valérie Andoblé; Folquet, Madeleine Amorissani; Dainguy, Marie-Evelyne; Kouakou, Cyrille; Méa-Assande, Véronique Tanoh; Oka-Berete, Gladys; Zobo, Nathalie; Acquah, Patrick; Kokora, Marie-Berthe; Eboua, Tanoh François; Timité-Konan, Marguerite; Ahoussou, Lucrèce Diecket; Assouan, Julie Kebé; Sami, Mabéa Flora; Kouadio, Clémence; Renner, Lorna; Goka, Bamenla; Welbeck, Jennifer; Sackey, Adziri; Owiafe, Seth Ntiri; Wejse, Christian; Silva, Zacarias José Da; Paulo, Joao; Rodrigues, Amabelia; da Silva, David; Medina, Candida; Oliviera-Souto, Ines; Ostergaard, Lars; Laursen, Alex; Sodemann, Morten; Aaby, Peter; Fomsgaard, Anders; Erikstrup, Christian; Eugen-Olsen, Jesper; Maïga, Moussa Y; Diakité, Fatoumata Fofana; Kalle, Abdoulaye; Katile, Drissa; Traore, Hamar Alassane; Minta, Daouda; Cissé, Tidiani; Dembelé, Mamadou; Doumbia, Mohammed; Fomba, Mahamadou; Kaya, Assétou Soukho; Traoré, Abdoulaye M; Traoré, Hamady; Toure, Amadou Abathina; Dicko, Fatoumata; Sylla, Mariam; Berthé, Alima; Traoré, Hadizatou Coulibaly; Koïta, Anta; Koné, Niaboula; N'diaye, Clémentine; Coulibaly, Safiatou Touré; Traoré, Mamadou; Traoré, Naïchata; Charurat, Man; Ajayi, Samuel; Dapiap, Stephen; Otu; Igbinoba, Festus; Benson, Okwara; Adebamowo, Clément; James, Jesse; Obaseki; Osakede, Philip; Olasode, John; Sow, Papa Salif; Diop, Bernard; Manga, Noël Magloire; Tine, Judicael Malick; Signate Sy, Haby; Ba, Abou; Diagne, Aida; Dior, Hélène; Faye, Malick; Gueye, Ramatoulaye Diagne; Mbaye, Aminata Diack; Patassi, Akessiwe; Kotosso, Awèrou; Kariyare, Benjamin Goilibe; Gbadamassi, Gafarou; Komi, Agbo; Mensah-Zukong, Kankoé Edem; Pakpame, Pinuwe; Lawson-Evi, Annette Koko; Atakouma, Yawo; Takassi, Elom; Djeha, Améyo; Ephoévi-Gah, Ayoko; Djibril, Sherifa El-Hadj; Dabis, François; Bissagnene, Emmanuel; Arrivé, Elise; Coffie, Patrick; Ekouevi, Didier; Jaquet, Antoine; Leroy, Valériane; Lewden, Charlotte; Sasco, Annie; Azani, Jean-Claude; Allou, Gérard; Balestre, Eric; Bohossou, Franck; Karcher, Sophie; Gonsan, Jules Mahan; Carrou, Jérôme Le; Lenaud, Séverin; Nchot, Célestin; Malateste, Karen; Yao, Amon Roseamonde; Siloué, Bertine; Clouet, Gwenaelle; Djetouan, Hugues; Doring, Alexandra; Kouakou, Adrienne; Rabourdin, Elodie; Rivenc, Jean; Anglaret, Xavier; Ba, Boubacar; Essanin, Jean Bosco; Ciaranello, Andrea; Datté, Sébastien; Desmonde, Sophie; Diby, Jean-Serge Elvis; Gottlieb, Geoffrey S; Horo, Apollinaire Gninlgninrin; Kangah, Serge N'zoré; Malvy, Denis; Meless, David; Mounkaila-Harouna, Aida; Ndondoki, Camille; Shiboski, Caroline; Thiébaut, Rodolphe; Pac-Ci; Abidjan
2013-01-01
HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART) for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework of the International epidemiological Databases to Evaluate AIDS (IeDEA). We collected data on all HIV-2 and HIV-1/HIV-2 dually seropositive patients (both ARV-naive and starting ART) and followed-up in clinical centres in the IeDEA-WA network including a total of 13 clinics in five countries: Benin, Burkina-Faso Côte d'Ivoire, Mali, and Senegal, in the West Africa region. Data was merged for 1,754 patients (56% female), including 1,021 HIV-2 infected patients (551 on ART) and 733 dually seropositive for both HIV-1 and HIV 2 (463 on ART). At ART initiation, the median age of HIV-2 patients was 45.3 years, IQR: (38.3-51.7) and 42.4 years, IQR (37.0-47.3) for dually seropositive patients (p = 0.048). Overall, 16.7% of HIV-2 patients on ART had an advanced clinical stage (WHO IV or CDC-C). The median CD4 count at the ART initiation is 166 cells/mm(3), IQR (83-247) among HIV-2 infected patients and 146 cells/mm(3), IQR (55-249) among dually seropositive patients. Overall, in ART-treated patients, the CD4 count increased 126 cells/mm(3) after 24 months on ART for HIV-2 patients and 169 cells/mm(3) for dually seropositive patients. Of 551 HIV-2 patients on ART, 5.8% died and 10.2% were lost to follow-up during the median time on ART of 2.4 years, IQR (0.7-4.3). This large multi-country study of HIV-2 and HIV-1/HIV-2 dual infection in West Africa suggests that routine clinical care is less than optimal and that management and treatment of HIV-2 could be further informed by ongoing studies and randomized clinical trials in this population.
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Directory of Open Access Journals (Sweden)
Didier K Ekouevi
Full Text Available HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework of the International epidemiological Databases to Evaluate AIDS (IeDEA.We collected data on all HIV-2 and HIV-1/HIV-2 dually seropositive patients (both ARV-naive and starting ART and followed-up in clinical centres in the IeDEA-WA network including a total of 13 clinics in five countries: Benin, Burkina-Faso Côte d'Ivoire, Mali, and Senegal, in the West Africa region.Data was merged for 1,754 patients (56% female, including 1,021 HIV-2 infected patients (551 on ART and 733 dually seropositive for both HIV-1 and HIV 2 (463 on ART. At ART initiation, the median age of HIV-2 patients was 45.3 years, IQR: (38.3-51.7 and 42.4 years, IQR (37.0-47.3 for dually seropositive patients (p = 0.048. Overall, 16.7% of HIV-2 patients on ART had an advanced clinical stage (WHO IV or CDC-C. The median CD4 count at the ART initiation is 166 cells/mm(3, IQR (83-247 among HIV-2 infected patients and 146 cells/mm(3, IQR (55-249 among dually seropositive patients. Overall, in ART-treated patients, the CD4 count increased 126 cells/mm(3 after 24 months on ART for HIV-2 patients and 169 cells/mm(3 for dually seropositive patients. Of 551 HIV-2 patients on ART, 5.8% died and 10.2% were lost to follow-up during the median time on ART of 2.4 years, IQR (0.7-4.3.This large multi-country study of HIV-2 and HIV-1/HIV-2 dual infection in West Africa suggests that routine clinical care is less than optimal and that management and treatment of HIV-2 could be further informed by ongoing studies and randomized clinical trials in this population.
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DEFF Research Database (Denmark)
Mouridsen, S.E.; Rich, B.; Isager, T.
2008-01-01
The objective of this study was to compare the prevalence and types of psychiatric disorders in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with psychiatric disorders in 336 matched controls from the general population using data from the nationwide Danish...
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Aspects of T-Dually Extended Superspaces
Polacek, Martin
This dissertation is divided into three main parts where we derive various properties of the T-dually extended superspaces. In the first part we reformulate the manifestly T-dual description of the massless sector of the closed bosonic string, directly from the geometry associated with the (left and right) affine Lie algebra of the coset space Poincare/Lorentz. This construction initially doubles not only the (space-time) coordinates for translations but also those for Lorentz transformations (and their "dual"). As a result, the Lorentz connection couples directly to the string (as does the vielbein), rather than being introduced indirectly through covariant derivatives as previously. This not only reproduces the old definition of T-dual torsion, but automatically gives a general, covariant definition of T-dual curvature (but still with some undetermined connections). In the second part we give the manifestly T-dual formulation of the massless sector of the classical 3D Type II superstring in off-shell 3D N = 2 superspace, including the action. It has a simple relation to the known superspace of 4D N = 1 supergravity in 4D M-theory via 5D F-theory. The pre-potential appears as part of the vielbein, without derivatives. In the last and the most involved part we find the pre-potential in the superspace with AdS5 x S5 background. The pre-potential appears as part of the vielbeins, without derivatives. In both subspaces (AdS5 and S 5) we use Poincare coordinates. We pick one bulk coordinate in AdS5 and one bulk coordinate in S 5 to define the space-cone gauge. Such space-cone gauge destroys the bulk Lorentz covariance. However, it still preserves boundary Lorentz covariance (and gives projective superspace) SO ( 3, 1) ⊗ SO (4) and so symmetries of boundary CFT are manifest.
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Smith, Isaac C.; Reichow, Brian; Volkmar, Fred R.
2015-01-01
A growing body of research has raised concerns about the number of individuals diagnosed with autism spectrum disorder (ASD) according to DSM-IV-TR who may no longer qualify for diagnoses under the new DSM-5 criteria, published in May 2013. The current study systematically reviews 25 articles evaluating samples according to both DSM-IV-TR and…
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A Population-based survey of risk for cancer in individuals diagnosed with myotonic dystrophy
Abbott, Diana; Johnson, Nicholas E; Cannon-Albright, Lisa A.
2018-01-01
Introduction The risk of cancer in patients diagnosed with myotonic dystrophy (DM) is reported for the homogeneous Utah population. Methods Clinical data accessed from the largest Utah healthcare providers have been record-linked to the Utah Population Database (UPDB), a population-based resource also linked to the Utah Cancer Registry. Relative risks were estimated for 36 cancers of different types in 281 DM patients. Results Testicular cancer (RR=10.74; 95% CI: 1.91, 38.79), endometrial cancer (6.98; 1.24, 25.22), and Non-Hodgkins lymphoma (4.25; 1.16, 12.43) were all observed at significant excess in DM patients. Discussion This study confirms an overall increased risk of cancer in DM. Individuals diagnosed with DM might benefit from risk counseling. PMID:27064430
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Directory of Open Access Journals (Sweden)
Ming-Lun Yeh
Full Text Available BACKGROUND: Interferon-α/ribavirin combination therapy might promote hepatitis B surface antigen (HBsAg seroclearance in patients dually infected with hepatitis B and C viruses (HBV/HCV, but the long-term effect remains unclear. We aimed to investigate the rate of and the factors associated with HBsAg seroclearance during long-term follow-up after interferon-α/ribavirin combination therapy in HBV/HCV dually-infected patients. METHODOLOGY/PRINCIPAL FINDINGS: Eighty-one patients who received interferon-α/ribavirin combination therapy for 24 weeks with a follow-up period of >24 weeks were enrolled. HBV serological markers and HBV DNA were determined every 6 months. Early and late HBsAg seroclearance were defined as HBsAg loss in less or more than 6 months after end-of-treatment, respectively. Fifteen (18.5% patients had HBsAg seroclearance during a mean follow-up period of 3.4 (0.5-5.1 years. The 5-year cumulative incidence was 25.6%. Baseline cirrhosis and HBV DNA negativity 1 year after end-of-treatment were independently predictive of HBsAg seroclearance with an odds ratio (OR, 95% confidence intervals (CI of 16.6, 1.8-153 and 9.2, 1.4-62.1, respectively, by Cox regression hazard analysis. Four patients developed early and 11 developed late HBsAg seroclearance, respectively. Cox regression hazard analysis showed no factor was associated with early HBsAg seroclearance, whilst HBV DNA negativity 1 year after end-of-treatment was the only significant factor predicting late HBsAg loss (OR, 43.0; CI, 2.5-745. Five patients had HBsAg seroconversion with a 5-year cumulative incidence of 8.3%. HBV DNA negativity at baseline and one year after EOT had a trend for HBsAg seroconversion. HCV response did not correlate to HBsAg loss. CONCLUSIONS: We demonstrated that interferon-α/ribavirin had long-term effect on HBsAg seroclearance in dually HBV/HCV-infected patients. Baseline cirrhosis and seroclearance of HBV DNA 1 year after end-of-treatment were
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Lakis, Nadia; Mendrek, Adrianna
2013-01-01
The majority of functional neuroimaging studies investigating neural correlates of emotion processing in schizophrenia report a significant deficit in limbic structures activation in patients relative to control participants. Recently it has been suggested that this apparent “deficit” could be due to an enhanced sensitivity of the neutral material in individuals diagnosed with schizophrenia, rather than due to their inefficiency in emotion processing. The purpose of the present study was to t...
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Leaf, Justin B.; Leaf, Jeremy A.; Milne, Christine; Taubman, Mitchell; Oppenheim-Leaf, Misty; Torres, Norma; Townley-Cochran, Donna; Leaf, Ronald; McEachin, John; Yoder, Paul
2017-01-01
In this study we evaluated a social skills group which employed a progressive applied behavior analysis model for individuals diagnosed with autism spectrum disorder. A randomized control trial was utilized; eight participants were randomly assigned to a treatment group and seven participants were randomly assigned to a waitlist control group. The…
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January, Kathleen; Conway, Laura J; Deardorff, Matthew; Harrington, Ann; Krantz, Ian D; Loomes, Kathleen; Pipan, Mary; Noon, Sarah E
2016-06-01
Given the clinical complexities of Cornelia de Lange Syndrome (CdLS), the Center for CdLS and Related Diagnoses at The Children's Hospital of Philadelphia (CHOP) and The Multidisciplinary Clinic for Adolescents and Adults at Greater Baltimore Medical Center (GBMC) were established to develop a comprehensive approach to clinical management and research issues relevant to CdLS. Little work has been done to evaluate the general utility of a multispecialty approach to patient care. Previous research demonstrates several advantages and disadvantages of multispecialty care. This research aims to better understand the benefits and limitations of a multidisciplinary clinic setting for individuals with CdLS and related diagnoses. Parents of children with CdLS and related diagnoses who have visited a multidisciplinary clinic (N = 52) and who have not visited a multidisciplinary clinic (N = 69) were surveyed to investigate their attitudes. About 90.0% of multispecialty clinic attendees indicated a preference for multidisciplinary care. However, some respondents cited a need for additional clinic services including more opportunity to meet with other specialists (N = 20), such as behavioral health, and increased information about research studies (N = 15). Travel distance and expenses often prevented families' multidisciplinary clinic attendance (N = 41 and N = 35, respectively). Despite identified limitations, these findings contribute to the evidence demonstrating the utility of a multispecialty approach to patient care. This approach ultimately has the potential to not just improve healthcare for individuals with CdLS but for those with medically complex diagnoses in general. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
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Smart Fluid System Dually Responsive to Light and Electric Fields: An Electrophotorheological Fluid.
Yoon, Chang-Min; Jang, Yoonsun; Noh, Jungchul; Kim, Jungwon; Jang, Jyongsik
2017-10-24
Electrophotorheological (EPR) fluids, whose rheological activity is dually responsive to light and electric fields (E fields), is formulated by mixing photosensitive spiropyran-decorated silica (SP-sSiO 2 ) nanoparticles with zwitterionic lecithin and mineral oil. A reversible photorheological (PR) activity of the EPR fluid is developed via the binding and releasing mechanism of lecithin and merocyanine (MC, a photoisomerized form of SP) under ultraviolet (UV) and visible (VIS) light applications. Moreover, the EPR fluid exhibits an 8-fold higher electrorheological (ER) performance compared to the SP-sSiO 2 nanoparticle-based ER fluid (without lecithin) under an E field, which is attributed to the enhanced dielectric properties facilitated by the binding of the lecithin and SP molecules. Upon dual application of UV light and an E field, the EPR fluid exhibits high EPR performance (ca. 115.3 Pa) that far exceeds its separate PR (ca. 0.8 Pa) and ER (ca. 57.5 Pa) activities, because of the synergistic contributions of the PR and ER effects through rigid and fully connected fibril-like structures. Consequently, this study offers a strategy on formulation of dual-stimuli responsive smart fluid systems.
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DEFF Research Database (Denmark)
Mouridsen, Svend-Erik; Rich, B; Isager, T
2009-01-01
Abstract Background A number of studies have indicated a link between gastrointestinal (GI) diseases and autism spectrum disorders. Method The objective of this study was to compare the prevalence and types of GI diseases in a clinical sample of 118 individuals diagnosed as children with infantile...... autism (IA) with GI diseases in 336 matched controls from the general population, based on data from the nationwide Danish National Hospital Register (DNHR). The average observation time was 30.3 years (SD 0.4) (range 27-30 years), and mean age at the end of the observation period was 42.7 years (SD 7...
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Yoon, Gihyun; Petrakis, Ismene L; Rosenheck, Robert A
2015-08-01
This study assesses medical and psychiatric comorbidities, service utilization, and psychotropic medication prescriptions in veterans with comorbid major depressive disorder (MDD) and alcohol use disorder (AUD) relative to veterans with MDD alone. Using cross-sectional administrative data (fiscal year [FY]2012: October 1, 2011-September 30, 2012) from the Veterans Health Administration (VHA), we identified veterans with a diagnosis of current (12-month) MDD nationally (N = 309,374), 18.8% of whom were also diagnosed with current (12-month) AUD. Veterans with both MDD and AUD were compared to those with MDD alone on sociodemographic characteristics, current (12-month) medical and psychiatric disorders, service utilization, and psychotropic prescriptions. We then used logistic regression analyses to calculate odds ratio and 95% confidence interval of characteristics that were independently different between the groups. Dually diagnosed veterans with MDD and AUD, relative to veterans with MDD alone, had a greater number of comorbid health conditions, such as liver disease, drug use disorders, and bipolar disorder as well as greater likelihood of homelessness and higher service utilization. Dually diagnosed veterans with MDD and AUD had more frequent medical and psychiatric comorbidities and more frequently had been homeless. These data suggest the importance of assessing the presence of comorbid medical/psychiatric disorders and potential homelessness in order to provide appropriately comprehensive treatment to dually diagnosed veterans with MDD and AUD and indicate a need to develop more effective treatments for combined disorders. © American Academy of Addiction Psychiatry.
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Sahnoun, Mouna; Ismail, Nouha; Kammoun, Radhouane
2016-01-01
Corn starch was treated by enzymatic hydrolysis with Aspergillus oryzae S2 α-amylase, acetylation with vinyl acetate, and dual modification. The dual modified starch displayed a higher substitution degree than the acetylated starch and lower reducing sugar content than the hydrolysed starch. The results revealed that the cooling viscosity and amylose content of those products decrease (P cake formulations at 5 and 10 % concentrations on a wheat flour basis and compared to native starch. The results revealed that when applied at 5 % concentrations, the modified starches reduced the hardness, cohesion, adhesion and chewiness of baked cakes and enhanced their elasticity, volume, height, crust color, and appearance as compared to native starch. These effects were more pronounced for the cake incorporating the dually modified starch.
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Baughman, Brandon C; Basso, Michael R; Sinclair, Robert R; Combs, Dennis R; Roper, Brad L
2015-01-01
People with multiple sclerosis (MS) are apt to become unemployed as the disease progresses, and most research implies that this is due to diminishing mobility. Some studies have shown that presence of cognitive impairment also predicts employment status. Yet, no studies have examined how neuropsychological factors predict vocational performance among individuals with MS who remain employed. We assessed employer- and self-rated work performance, mobility status, and neuropsychological function in a sample of 44 individuals diagnosed with MS. Results suggest that cognitive impairment is common in these employed individuals, despite largely intact mobility status. Moreover, a significant interaction emerged, such that cognitively impaired individuals' work performance was rated more poorly by supervisors. In contrast, self-ratings of work performance were higher in cognitively impaired than in unimpaired participants. These novel findings suggest that cognitive impairment may influence work performance, even in patients whose physical disability status is relatively intact.
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Dong, Yanfeng; Zhao, Zongbin; Wang, Zhiyu; Liu, Yang; Wang, Xuzhen; Qiu, Jieshan
2015-02-04
Dually fixed SnO2 nanoparticles (DF-SnO2 NPs) on graphene nanosheets by a polyaniline (Pani) coating was successfully fabricated via two facile wet chemistry processes, including anchoring SnO2 NPs onto graphene nanosheets via reducing graphene oxide by Sn(2+) ion, followed by in situ surface sealing with the Pani coating. Such a configuration is very appealing anode materials in LIBs due to several structural merits: (1) it prevents the aggregation of SnO2 NPs, (2) accommodates the structural expanding of SnO2 NPs during lithiation, (3) ensures the stable as-formed solid electrolyte interface films, and (4) effectively enhances the electronic conductivity of the overall electrode. Therefore, the final DF-SnO2 anode exhibits stable cycle performance, such as a high capacity retention of over 90% for 400 cycles at a current density of 200 mA g(-1) and a long cycle life up to 700 times at a higher current density of 1000 mA g(-1).
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Experiences of being diagnosed with osteoporosis
DEFF Research Database (Denmark)
Rothmann, Mette Juel; Jakobsen, P R; Myhre Jensen, Charlotte
2018-01-01
This systematic review provides synthesised knowledge and guidance to health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point of view. Using individuals' experiences and meanings can promote tailored and targeted information...... an individual's experience of being diagnosed with osteoporosis at different stages, and secondly, to use a systematic approach to develop a conceptual understanding of central issues relevant for health professionals in order to provide support and guidance to patients/individuals. METHODS: This study used...... of the diagnosis based on self-perceived fracture risk, self-perceived severity of osteoporosis and at the same time, self-perceived health. CONCLUSIONS: This meta-synthesis provides knowledge for health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point...
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Social functioning and internalized stigma in individuals diagnosed with substance use disorder.
Can, Ganime; Tanrıverdi, Derya
2015-12-01
The aim of this descriptive study was to determine social functioning and internalized stigma in individuals with substance use disorder. The study sample consisted of 105 patients diagnosed with substance use disorder according to the DSM-IV-TR diagnostic criteria. A Descriptive Information Form, Internalized Stigma of Mental Illness Scale (ISMI) and Social Functioning Scale (SFS) were used for data collection. Average total SFS score of the patients was 103.25±25.09 points, indicating an intermediate level of social functioning. Average total ISMI score of patients was 2.92±0.48 points, reflecting a high level of internalized stigma. A negative significant association was observed between the internalized stigma levels and social functioning of patients. These results suggest that rehabilitation of substance users should include counseling services in order to reduce internal perception of stigma and improve their social functioning. Copyright © 2015 Elsevier Inc. All rights reserved.
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Ou, Yanghao; Chen, Jinbo; Lu, Pengbo; Cheng, Fan; Lin, Meiyan; Su, Lingfeng; Li, Jun; Liu, Detao
2017-07-31
Biodegradable highly nanostructured paper has received great interest in past years due to its excellent optical properties which facilitate its wide applications in green flexible electronics and devices. However, energy and/or time-consuming procedure during the process of fabricating most nanostructured transparent paper are presently the main obstacle to their scalable production. In this work, we demonstrated a novel nanostructured paper with dually high transparency (∼91%) and high haze (∼89%) that was directly fabricated from original paper with rapid ILs-polishing processes. The whole fabricating time only requires 10 min. Compared to the previously reported nanopaper made of the isolated cellulose nanofibers by pure mechanical and/or chemical approaches, this work presented herein is devoted to use green ILs to polish directly the micrometer-sized fibrous paper into the nanostructured paper. This new method brings a rapid fabrication of transparent nanostructured paper while also retaining dual intriguing properties both in optical transmittance and haze. This work is capable of fabricating next-generation flexible and highly transparent and haze paper by a high-speed roll-to-roll manufacturing process with a much lower cost.
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Diseases of the gastrointestinal tract in individuals diagnosed as children with atypical autism
DEFF Research Database (Denmark)
Mouridsen, Svend Erik Birkebæk; Isager, Torben; Rich, Bente
2013-01-01
The purpose of this study is to compare the prevalence and types of diseases (International Classification of Mental and Behavioural Disorders, 10th Edition codes K20-K93) relating to the gastrointestinal tract in a clinical sample of 89 individuals diagnosed as children with atypical autism...... with atypical autism, a total of 22 (24.7%) were registered with at least one diagnosis of any disease of the gastrointestinal tract, against 47 of 258 (18.2%) in the comparison group (p = 0.22; odds ratio = 1.5; 95% confidence interval = 0.8-2.6). Without reaching statistical significance, the rate of diseases...... of the gastrointestinal tract was particularly high (odds ratio = 1.2) in those with intelligence quotient autism had about the same frequency of gastric, intestinal and hepatic diseases as had controls....
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DEFF Research Database (Denmark)
Mouridsen, Svend-Erik; Rich, Bente; Isager, Torben
2012-01-01
observation time was 30.3 years (range 27.3-30.4 years), and mean age at follow-up was 42.7 years (range 27.3-57.3 years). Of the 118 individuals with IA, 14 (11.9%) were registered with at least one fracture diagnosis against 83 (24.7%) in the comparison group (p = 0.004; OR = 0.41; 95%CI 0......We compared the prevalence and types of fractures in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with 336 matched controls from the general population. All participants were screened through the nationwide Danish National Hospital Register. The average.......22-0.76), but the nature of their fractures seems somewhat different. Epilepsy was a risk factor, but only in the comparison group. Our results lend no support to the notion that fracture is a common comorbid condition in a population of people diagnosed with IA as children....
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Teaching Self-Control to Small Groups of Dually Diagnosed Adults.
Dixon, Mark R.; Holcomb, Sharon
2000-01-01
A study used a progressive delay procedure to teach self-control to six adults with mental retardation. At baseline, participants chose an immediate smaller reinforcer rather than a larger delayed reinforcer. Progressive increases in work requirements for gaining access to a larger reinforcer resulted in participants selecting larger delayed…
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Teaching Self-Control to Dually Diagnosed Deaf Students: Promising Procedures.
Morrow, Lonny W.
1985-01-01
Three pilot studies suggested that deaf multiply disabled students (ages 15-18) can learn and implement self-control strategies while becoming more independent and engaging in more age-appropriate prosocial behavior. Use of the skills was maintained and appeared to generalize to other school and nonschool environments. (CL)
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Quality of life among dually diagnosed and non-substance-using ...
African Journals Online (AJOL)
legal problems and family stress. .... changes in QoL were related to changes ... QoL = quality of life; WHOQOL-BREF = The World Health Organization Quality of Life ... which is consistent with most of the studies in the literature. ..... use prevalence in the workplace: A comparison of self report, urinalysis, and hair analysis. Int.
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Child abuse predicts adult PTSD symptoms among individuals diagnosed with intellectual disabilities
Directory of Open Access Journals (Sweden)
Claudia eCatani
2015-10-01
Full Text Available Prior research has shown that people with intellectual disabilities (ID are more likely to experience child abuse as well as other forms of traumatic events later in life compared to the general population. Little is known however, about the association of these experiences with adult mental health in individuals with ID. The present study aimed to assess whether child abuse in families and institutions as well as other types of adverse life events, were associated with current Posttraumatic Stress Disorder (PTSD and depression symptoms in individuals with ID. We conducted clinical interviews which included standardized self-report measures for childhood abuse, PTSD, and depression in an unselected sample of 56 persons with a medical diagnosis of intellectual disability who were attending a specialized welfare center. The frequency of traumatic experiences was very high, with physical and emotional child abuse being the most common trauma types. 87% of the persons reported at least one aversive experience on the family violence spectrum, and 50% of the sample reported a violent physical attack later in adulthood. 25% were diagnosed with PTSD and almost 27% had a critical score on the depression scale. Physical and emotional child abuse was positively correlated with the amount of institutional violence and the number of general traumatic events, whereas childhood sexual abuse was related to the experience of intimate partner violence in adult life. A linear regression revealed child abuse in the family to be the only significant independent predictor of PTSD symptom severity. The current findings underscore the central role of child maltreatment in the increased risk of further victimization and in the development of mental health problems in adulthood in individuals with ID. Our data have important clinical implications and demonstrate the need for targeted prevention and intervention programs that are tailored to the specific needs of children
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Directory of Open Access Journals (Sweden)
Nilgun Kuru
2012-06-01
Full Text Available AIM: The aim of the study, Coronary Artery Disease (CAD diagnosed with identification of individuals in specific behaviors to improve health, health status and related factors to determine the levels of detection. METHODS: This descriptive study of data types of the Gulhane Military Medical Academy (GATA Hospital cardiology clinic in December 2009 - February 2010 were collected. The study group, at least 6 months before the diagnosis of CAD area, between the ages of 20-65 individuals who accept and participate in the study (n = 300 formed. Sociodemographic characteristics and health behaviors of the personal information form for the 33-item, 52-item scale of a healthy lifestyle behaviors and health status of the single-item scale working group of the detection technique applied to the face-to-face interview. The aim of the study, Coronary Artery Disease (CAD for the development of health behaviors in the case of individuals diagnosed with the identification, health status and related factors to determine the levels of detection. The statistical analysis techniques such as Mann Whitney U and Kruskal-Wallis were used for the comparison. RESULTS: Of the group 57,7% were males, 46,3% were 50-59 years of age and 56,3% were higher education graduates. As regard to total Health Promotion Life-Style Profile Scale scores statistically significant differences had been found between age, gender, education, disease period, occupation and chronic condition groups. As regard to the average PHSS scores statistically significant differences had been found between age, education, body mass index, disease period, occupation, chronic condition and CAD related course groups (p<0.05. CONCLUSION: Healthy lifestyle behaviors before planning training programs, individual models of health behavior and the behavior of individuals using the analyzed factors affecting.. [TAF Prev Med Bull 2012; 11(3.000: 287-298
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Huskamp, Haiden A; Samples, Hillary; Hadland, Scott E; McGinty, Emma E; Gibson, Teresa B; Goldman, Howard H; Busch, Susan H; Stuart, Elizabeth A; Barry, Colleen L
2018-02-01
The Mental Health Parity and Addiction Equity Act (MHPAEA) was intended to eliminate differences in insurance coverage for mental health and substance use disorder services and medical-surgical care. No studies have examined mental health service use after federal parity implementation among individuals with diagnoses of eating disorders, for whom financial access to care has often been limited. This study examined whether MHPAEA implementation was associated with changes in use of mental health services and spending in this population. Using Truven Health MarketScan data from 2007 to 2012, this study examined trends in mental health spending and intensity of use of specific mental health services (inpatient days, total outpatient visits, psychotherapy visits, and medication management visits) among individuals ages 13-64 with a diagnosis of an eating disorder (N=27,594). MHPAEA implementation was associated with a small increase in total mental health spending ($1,271.92; p<.001) and no change in out-of-pocket spending ($112.99; p=.234) in the first year after enforcement of the parity law. The law's implementation was associated with an increased number of outpatient mental health visits among users, corresponding to an additional 5.8 visits on average during the first year (p<.001). This overall increase was driven by an increase in psychotherapy use of 2.9 additional visits annually among users (p<.001). MHPAEA implementation was associated with increased intensity of outpatient mental health service use among individuals with diagnoses of eating disorders but no increase in out-of-pocket expenditures, suggesting improvements in financial protection.
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Mouridsen, Svend Erik; Rich, Bente; Isager, Torben
2012-01-01
We compared the prevalence and types of fractures in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with 336 matched controls from the general population. All participants were screened through the nationwide Danish National Hospital Register. The average observation time was 30.3 years (range 27.3-30.4…
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Transmitted drug resistance and type of infection in newly diagnosed HIV-1 individuals in Honduras.
Murillo, Wendy; Paz-Bailey, Gabriela; Morales, Sonia; Monterroso, Edgar; Paredes, Mayte; Dobbs, Trudy; Parekh, Bharat S; Albert, Jan; Rivera, Ivette Lorenzana de
2010-12-01
Transmitted drug resistance (TDR) reduces the efficacy of antiretroviral treatment and is a public health concern. To gain insight in the epidemiology of TDR in Honduras by evaluating the amount of TDR in a representative sample of newly diagnosed individuals and by determining whether these are recent or established infections. Two hundred treatment-naïve, newly diagnosed HIV-positive individuals representing different population groups (general population, Garifunas ethnic group, female sex workers and men who have sex with men) and different geographic regions were enrolled during April 2004-April 2007. The HIV-1 pol gene was sequenced to identify drug-resistant mutations and TDR was scored as recommended by the WHO. Specimens were classified as recent or established infections using the BED assay. Among 200 samples analyzed from Honduran patients the prevalence of TDR was 7% (95% CI: 3.9-11.5%), 5% for non-nucleoside reverse transcriptase inhibitors (NNRTIs), 3% for nucleoside reverse transcriptase inhibitors (NRTIs) and 0.5% for protease inhibitors (PIs). Testing of these samples with the BED assay revealed that 12% of the specimens were associated with recent infections. TDR was significantly more common in specimens with recent infection (21%) than established infection (5%) (p=0.016). The prevalence of TDR in Honduras was moderate (7%). The percentage of specimens who were recently infected was low (12%), suggesting that late HIV diagnosis is common. The TDR prevalence was higher in recent than in established infections, which may indicate that TDR is increasing over time. The higher prevalence of NNRTI and NRTI mutations as compared to PI mutations is probably due to a broader and longer use of these drugs in Honduras. Copyright © 2010 Elsevier B.V. All rights reserved.
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DEFF Research Database (Denmark)
Hjorthøj, Carsten Rygaard; Vesterager, Lone; Nordentoft, Merete
2013-01-01
Background: The New Adult Reading Test is a common instrument for assessing pre-morbid IQ for patients with, for instance, schizophrenia. However, test-retest reliability has not been established for patients dually diagnosed with psychosis and substance use disorder. Furthermore, test......-retest reliability of the Danish adaptation has never been established in any population. Aims: To determine the test-retest reliability of the Danish Adult Reading Test (DART) (adapted from the National Adult Reading Test, NART) for patients dually diagnosed with psychosis and cannabis-use disorder. Methods......: This was a secondary analysis of the CapOpus randomized trial. As part of the trial, 103 patients were randomized, and completed the DART up to three times. Pearson's r and pairwise t-tests were calculated. Results: DART score was independent of randomization, cannabis-use frequency and psychopathology. Scores...
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DEFF Research Database (Denmark)
Audelin, Anne Margrethe; Gerstoft, Jan; Obel, Niels
2011-01-01
Abstract Highly active antiretroviral treatment is compromised by viral resistance mutations. Transmitted drug resistance (TDR) is therefore monitored closely, but follow-up studies of these patients are limited. Virus from 1405 individuals diagnosed with HIV-1 in Denmark between 2001 and 2009...... without resistance mutations. We observed no difference in progression of the infection between individuals infected with TDR and individuals infected with wild-type HIV-1. The prevalence of TDR is low in Denmark and transmission of dual-drug-resistant HIV-1 is infrequent. The TDR isolates were shown...... resulting in a prevalence of 6.1%, with no changes over time. The main resistance mutations were nucleoside reverse transcriptase inhibitor (NRTI) mutation 215 revertants, as well as nonnucleoside reverse transcriptase inhibitor (NNRTI) mutation 103N/S and protease inhibitor (PI) mutations 90M and 85V...
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DEFF Research Database (Denmark)
Audelin, Anne Margrethe; Gerstoft, Jan; Obel, Niels
2011-01-01
Abstract Highly active antiretroviral treatment is compromised by viral resistance mutations. Transmitted drug resistance (TDR) is therefore monitored closely, but follow-up studies of these patients are limited. Virus from 1405 individuals diagnosed with HIV-1 in Denmark between 2001 and 2009...... without resistance mutations. We observed no difference in progression of the infection between individuals infected with TDR and individuals infected with wild-type HIV-1. The prevalence of TDR is low in Denmark and transmission of dual-drug-resistant HIV-1 is infrequent. The TDR isolates were shown...... resulting in a prevalence of 6.1%, with no changes over time. The main resistance mutations were nucleoside reverse transcriptase inhibitor (NRTI) mutation 215 revertants, as well as nonnucleoside reverse transcriptase inhibitor (NNRTI) mutation 103N/S and protease inhibitor (PI) mutations 90M and 85V...
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Injury Patterns among Individuals Diagnosed with Infantile Autism during Childhood
DEFF Research Database (Denmark)
Mouridsen, Svend-Erik; Rich, Bente; Isager, Torben
2016-01-01
Background: To date, injury risk among people with infantile autism (IA) has been a relatively poorly researched issue.Objective:The purpose of our study was to compare the prevalence and types of injuries in a clinical sample of 118 patients diagnosed with IA during childhood with those of 336 age...
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Lu, Xinli; Kang, Xianjiang; Liu, Yongjian; Cui, Ze; Guo, Wei; Zhao, Cuiying; Li, Yan; Chen, Suliang; Li, Jingyun; Zhang, Yuqi; Zhao, Hongru
2017-01-01
New human immunodeficiency virus type 1 (HIV-1) diagnoses are increasing rapidly in Hebei. The aim of this study presents the most extensive HIV-1 molecular epidemiology investigation in Hebei province in China thus far. We have carried out the most extensive systematic cross-sectional study based on newly diagnosed HIV-1 positive individuals in 2013, and characterized the molecular epidemiology of HIV-1 based on full length gag-partial pol gene sequences in the whole of Hebei. Nine HIV-1 genotypes based on full length gag-partial pol gene sequence were identified among 610 newly diagnosed naïve individuals. The four main genotypes were circulating recombinant form (CRF)01_AE (53.4%), CRF07_BC (23.4%), subtype B (15.9%), and unique recombinant forms URFs (4.9%). Within 1 year, three new genotypes (subtype A1, CRF55_01B, CRF65_cpx), unknown before in Hebei, were first found among men who have sex with men (MSM). All nine genotypes were identified in the sexually contracted HIV-1 population. Among 30 URFs, six recombinant patterns were revealed, including CRF01_AE/BC (40.0%), CRF01_AE/B (23.3%), B/C (16.7%), CRF01_AE/C (13.3%), CRF01_AE/B/A2 (3.3%) and CRF01_AE/BC/A2 (3.3%), plus two potential CRFs. This study elucidated the complicated characteristics of HIV-1 molecular epidemiology in a low HIV-1 prevalence northern province of China and revealed the high level of HIV-1 genetic diversity. All nine HIV-1 genotypes circulating in Hebei have spread out of their initial risk groups into the general population through sexual contact, especially through MSM. This highlights the urgency of HIV prevention and control in China.
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Directory of Open Access Journals (Sweden)
Xinli Lu
Full Text Available New human immunodeficiency virus type 1 (HIV-1 diagnoses are increasing rapidly in Hebei. The aim of this study presents the most extensive HIV-1 molecular epidemiology investigation in Hebei province in China thus far. We have carried out the most extensive systematic cross-sectional study based on newly diagnosed HIV-1 positive individuals in 2013, and characterized the molecular epidemiology of HIV-1 based on full length gag-partial pol gene sequences in the whole of Hebei. Nine HIV-1 genotypes based on full length gag-partial pol gene sequence were identified among 610 newly diagnosed naïve individuals. The four main genotypes were circulating recombinant form (CRF01_AE (53.4%, CRF07_BC (23.4%, subtype B (15.9%, and unique recombinant forms URFs (4.9%. Within 1 year, three new genotypes (subtype A1, CRF55_01B, CRF65_cpx, unknown before in Hebei, were first found among men who have sex with men (MSM. All nine genotypes were identified in the sexually contracted HIV-1 population. Among 30 URFs, six recombinant patterns were revealed, including CRF01_AE/BC (40.0%, CRF01_AE/B (23.3%, B/C (16.7%, CRF01_AE/C (13.3%, CRF01_AE/B/A2 (3.3% and CRF01_AE/BC/A2 (3.3%, plus two potential CRFs. This study elucidated the complicated characteristics of HIV-1 molecular epidemiology in a low HIV-1 prevalence northern province of China and revealed the high level of HIV-1 genetic diversity. All nine HIV-1 genotypes circulating in Hebei have spread out of their initial risk groups into the general population through sexual contact, especially through MSM. This highlights the urgency of HIV prevention and control in China.
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Bramswig, Nuria C; Lüdecke, Hermann-Josef; Alanay, Yasemin; Albrecht, Beate; Barthelmie, Alexander; Boduroglu, Koray; Braunholz, Diana; Caliebe, Almuth; Chrzanowska, Krystyna H; Czeschik, Johanna Christina; Endele, Sabine; Graf, Elisabeth; Guillén-Navarro, Encarna; Kiper, Pelin Özlem Simsek; López-González, Vanesa; Parenti, Ilaria; Pozojevic, Jelena; Utine, Gulen Eda; Wieland, Thomas; Kaiser, Frank J; Wollnik, Bernd; Strom, Tim M; Wieczorek, Dagmar
2015-06-01
Coffin-Siris syndrome (CSS) and Nicolaides-Baraitser syndrome (NCBRS) are rare intellectual disability/congenital malformation syndromes that represent distinct entities but show considerable clinical overlap. They are caused by mutations in genes encoding members of the BRG1- and BRM-associated factor (BAF) complex. However, there are a number of patients with the clinical diagnosis of CSS or NCBRS in whom the causative mutation has not been identified. In this study, we performed trio-based whole-exome sequencing (WES) in ten previously described but unsolved individuals with the tentative diagnosis of CSS or NCBRS and found causative mutations in nine out of ten individuals. Interestingly, our WES analysis disclosed overlapping differential diagnoses including Wiedemann-Steiner, Kabuki, and Adams-Oliver syndromes. In addition, most likely causative de novo mutations were identified in GRIN2A and SHANK3. Moreover, trio-based WES detected SMARCA2 and SMARCA4 deletions, which had not been annotated in a previous Haloplex target enrichment and next-generation sequencing of known CSS/NCBRS genes emphasizing the advantages of WES as a diagnostic tool. In summary, we discuss the phenotypic and diagnostic challenges in clinical genetics, establish important differential diagnoses, and emphasize the cardinal features and the broad clinical spectrum of BAF complex disorders and other disorders caused by mutations in epigenetic landscapers.
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Jespersen, Sanne; Hønge, Bo Langhoff; Esbjörnsson, Joakim; Medina, Candida; da Silva Té, David; Correira, Faustino Gomes; Laursen, Alex Lund; Østergaard, Lars; Andersen, Andreas; Aaby, Peter; Erikstrup, Christian; Wejse, Christian
2016-02-01
Several studies have reported conflicting effects of sex on HIV-1 infection. We describe differences in baseline characteristics and assess the impact of sex on HIV progression among patients at a clinic with many HIV-2 and HIV-1/2 dually infected patients. This study utilised a retrospective cohort of treatment-naïve adults at the largest HIV clinic in Guinea-Bissau from 6 June 2005 to 1 December 2013. Baseline characteristics were assessed and the patients followed until death, transfer, loss to follow-up, or 1 June 2014. We estimated the time from the first clinic visit until initiation of ART, death or loss to follow-up using Cox proportional hazard models. A total of 5694 patients were included in the study, 3702 women (65%) and 1992 men (35%). Women were more likely than men to be infected with HIV-2 (19% vs. 15%, P < 0.01) or dually infected with HIV-1/2 (11% vs. 9%, P = 0.02). For all HIV types, women were younger (median 35 vs. 40 years), less likely to have schooling (55% vs. 77%) or to be married (46% vs. 67%), and had higher baseline CD4 cell counts (median 214 vs. 178 cells/μl). Men had a higher age-adjusted mortality rate (hazard rate ratio (HRR) 1.29, 95% confidence interval (CI) 1.09-1.52) and were more often lost to follow-up (HRR 1.27, 95% CI 1.17-1.39). Significant differences exist between HIV-infected men and women regardless of HIV type. Men seek treatment at a later stage and, despite better socio-economic status, have higher mortality and loss to follow-up than women. © 2015 John Wiley & Sons Ltd.
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McKone, Elinor; Wan, Lulu; Robbins, Rachel; Crookes, Kate; Liu, Jia
2017-07-01
The Cambridge Face Memory Test (CFMT) is widely accepted as providing a valid and reliable tool in diagnosing prosopagnosia (inability to recognize people's faces). Previously, large-sample norms have been available only for Caucasian-face versions, suitable for diagnosis in Caucasian observers. These are invalid for observers of different races due to potentially severe other-race effects. Here, we provide large-sample norms (N = 306) for East Asian observers on an Asian-face version (CFMT-Chinese). We also demonstrate methodological suitability of the CFMT-Chinese for prosopagnosia diagnosis (high internal reliability, approximately normal distribution, norm-score range sufficiently far above chance). Additional findings were a female advantage on mean performance, plus a difference between participants living in the East (China) or the West (international students, second-generation children of immigrants), which we suggest might reflect personality differences associated with willingness to emigrate. Finally, we demonstrate suitability of the CFMT-Chinese for individual differences studies that use correlations within the normal range.
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Validation of the Inventory of Depressive Symptomatology (IDS) in Cocaine Dependent Inmates.
Suris, Alina; Kashner, T. Michael; Gillaspy, James A., Jr.; Biggs, Melanie; Rush, A. John
2001-01-01
While the reliability and validity of Inventory of Depressive Symptomatology (IDS) scores have been established with outpatient adults being treated in community psychiatric clinics, it has not been used in special or dually diagnosed populations. Establishes internal consistency, concurrent validity, and construct validity for both the clinical…
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Leaf, Justin B; Leaf, Jeremy A; Milne, Christine; Taubman, Mitchell; Oppenheim-Leaf, Misty; Torres, Norma; Townley-Cochran, Donna; Leaf, Ronald; McEachin, John; Yoder, Paul
2017-02-01
In this study we evaluated a social skills group which employed a progressive applied behavior analysis model for individuals diagnosed with autism spectrum disorder. A randomized control trial was utilized; eight participants were randomly assigned to a treatment group and seven participants were randomly assigned to a waitlist control group. The social skills group consisted of 32, 2 h sessions. Teachers implemented a variety of behaviorally based procedures. A blind evaluator measured participants' behavior immediately prior to intervention, immediately following intervention, and during 16 and 32-week maintenance probes. Results of the study demonstrated that participants made significant improvements with their social behavior (p < .001) following intervention, and the results were maintained up to 32 weeks after intervention had concluded.
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Bai, Mei; Dixon, Jane; Williams, Anna-Leila; Jeon, Sangchoon; Lazenby, Mark; McCorkle, Ruth
2016-11-01
Research shows that spiritual well-being correlates positively with quality of life (QOL) for people with cancer, whereas contradictory findings are frequently reported with respect to the differentiated associations between dimensions of spiritual well-being, namely peace, meaning and faith, and QOL. This study aimed to examine individual patterns of spiritual well-being among patients newly diagnosed with advanced cancer. Cluster analysis was based on the twelve items of the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale at Time 1. A combination of hierarchical and k-means (non-hierarchical) clustering methods was employed to jointly determine the number of clusters. Self-rated health, depressive symptoms, peace, meaning and faith, and overall QOL were compared at Time 1 and Time 2. Hierarchical and k-means clustering methods both suggested four clusters. Comparison of the four clusters supported statistically significant and clinically meaningful differences in QOL outcomes among clusters while revealing contrasting relations of faith with QOL. Cluster 1, Cluster 3, and Cluster 4 represented high, medium, and low levels of overall QOL, respectively, with correspondingly high, medium, and low levels of peace, meaning, and faith. Cluster 2 was distinguished from other clusters by its medium levels of overall QOL, peace, and meaning and low level of faith. This study provides empirical support for individual difference in response to a newly diagnosed cancer and brings into focus conceptual and methodological challenges associated with the measure of spiritual well-being, which may partly contribute to the attenuated relation between faith and QOL.
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Catalytic Oxidation of Soot on a Novel Active Ca-Co Dually-Doped Lanthanum Tin Pyrochlore Oxide
Directory of Open Access Journals (Sweden)
Lijie Ai
2018-04-01
Full Text Available A novel active Ca-Co dually-doping pyrochlore oxide La2−xCaxSn2−yCoyO7 catalyst was synthesized by the sol-gel method for catalytic oxidation of soot particulates. The microstructure, atomic valence, reduction, and adsorption performance were investigated by X-ray powder diffraction (XRD, scanning electron microscope (SEM, Fourier-transform infrared spectroscopy (FT-IR, X-ray photoelectron spectroscopy (XPS, H2-TPR (temperature-programmed reduction, and in situ diffuse reflection infrared Fourier transformed (DRIFTS techniques. Temperature programmed oxidation (TPO tests were performed with the mixture of soot-catalyst under tight contact conditions to evaluate the catalytic activity for soot combustion. Synergetic effect between Ca and Co improved the structure and redox properties of the solids, increased the surface oxygen vacancies, and provided a suitable electropositivity for oxide, directly resulting in the decreased ignition temperature for catalyzed soot oxidation as low as 317 °C. The presence of NO in O2 further promoted soot oxidation over the catalysts with the ignition temperature decreased to about 300 °C. The DRIFTS results reveal that decomposition of less stable surface nitrites may account for NO2 formation in the ignition period of soot combustion, which thus participate in the auxiliary combustion process.
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McEvoy, Beth; O'Connor, John; McCarthy, Odhran
2016-01-01
The diagnostic category of social anxiety disorder (SAD) is one that is widely drawn upon in mental health settings; SAD is primarily characterized by a marked fear of social performance situations and possible scrutiny by other people (American Psychiatric Association [APA], 1994, 2013). The current study aims to explore the experiences of people diagnosed with SAD. Psychoanalytically informed research interviews, drawing on psychoanalytic ideas around the parameters of engagement and levels of engagement and analysis, were carried out with 4 male and 2 female participants with diagnoses of SAD. Four themes emerged strongly, reflecting the content and process of interviews: "A Critical Voice," "A Passive Presence," "Failure to Launch," and "Behind the Mask." These emerging themes and the overall findings are conceptualized through a Winnicottian lens, emphasising the role of the good-enough mother and facilitating environment in the struggle of participants to achieve an experience of individuation as well as authenticity with others. Theoretical, clinical, and research implications are discussed, including the need for clinicians to consider the role of early parent-child dynamics and the overall home environment and what these have left in the here and now for people presenting in this way, particularly in the way services are used and the therapeutic relationship develops. Further research into underlying dynamic issues in the origins and maintenance of social anxiety is proposed.
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Diabetes education and self-management for ongoing and newly diagnosed (DESMOND)
DEFF Research Database (Denmark)
Skinner, T. Chas; Carey, Marian E.; Cradock, Sue
2006-01-01
diagnosed with Type 2 diabetes changes key illness beliefs and that these changes predict quality of life and metabolic control at 3-month follow-up. Practice implications: Newly diagnosed individuals are open to attending self-management programs and, if the program is theoretically driven, can......Objective: To determine the effects of a structured education program on illness beliefs, quality of life and physical activity in people newly diagnosed with Type 2 diabetes. Methods: Individuals attending a diabetes education and self-management for ongoing and newly diagnosed (DESMOND) program...... in 12 Primary Care Trusts completed questionnaire booklets assessing illness beliefs and quality of life at baseline and 3-month follow-up, metabolic control being assessed through assay of HbA1c. Results: Two hundred and thirty-six individuals attended the structured self-management education sessions...
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A Systematic Review of the Autism Research with Children Who Are Deaf or Hard of Hearing
Hansen, Sarah; Scott, Jessica
2018-01-01
The current study is a systematic review on the available evidence on language development, assessment, challenging behavior, and instruction for children dually diagnosed with autism spectrum disorder and deafness. Results indicate a strong need for additional research in these areas, especially in the areas of evidence-based practices.
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Sociodemographic Study of Danish Individuals Diagnosed with Transsexualism
DEFF Research Database (Denmark)
Simonsen, Rikke; Hald, Gert Martin; Giraldi, Annamaria
2015-01-01
INTRODUCTION: Male-to-female (MtF) and female-to-male (FtM) individuals with transsexualism (International Classification of Diseases-10) may differ in core clinical and sociodemographic variables such as age, sexual orientation, marriage and parenthood, school, educational level, and employment......F individuals. Compared with MtF, FtM had a significantly lower onset age (before 12 years of age) and lower age when permission for SRS was granted. Further, FtM individuals were significantly more often gynephilic (sexually attracted to females) during research period and less likely to start self......-initiated hormonal sex reassignment (SR) (treatment with cross-sex hormones). The MtF and FtM groups did not differ in years of school, educational level, employment, or engagement in marriage and cohabitation. CONCLUSIONS: As approximately half of MtF started cross-sex hormonal SR without attending a gender unit...
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Outcome Data for MICA Clients after Participation in an Institutional Therapeutic Community
Van Stelle, Kit R.; Moberg, D. Paul
2004-01-01
The current study assessed the effectiveness of a prison-based substance abuse treatment therapeutic community (TC) providing treatment to male inmates dually diagnosed with both substance abuse and mental health disorders. The findings show a short-term impact of the program on arrest after release, with program participants significantly less…
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Directory of Open Access Journals (Sweden)
Zhonghui Zhang
2015-04-01
Full Text Available miR-302/367 is the most abundant miRNA cluster in human embryonic stem cells (hESCs and can promote somatic cell reprogramming. However, its role in hESCs remains poorly understood. Here, we studied functional roles of the endogenous miR-302/367 cluster in hESCs by employing specific TALE-based transcriptional repressors. We revealed that miR-302/367 cluster dually regulates hESC cell cycle and apoptosis in dose-dependent manner. Gene profiling and functional studies identified key targets of the miR-302/367 cluster in regulating hESC self-renewal and apoptosis. We demonstrate that in addition to its role in cell cycle regulation, miR-302/367 cluster conquers apoptosis by downregulating BNIP3L/Nix (a BH3-only proapoptotic factor and upregulating BCL-xL expression. Furthermore, we show that butyrate, a natural compound, upregulates miR-302/367 cluster expression and alleviates hESCs from apoptosis induced by knockdown of miR-302/367 cluster. In summary, our findings provide new insights in molecular mechanisms of how miR-302/367 cluster regulates hESCs.
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Life expectancies for individuals with psychiatric diagnoses.
Hannerz, H; Borgå, P; Borritz, M
2001-09-01
The aim of the study was to estimate life expectancies in different diagnostic groups for individuals treated as inpatients at Swedish psychiatric clinics. All individuals, older than 18 y and alive on the first of January 1983, who had been registered in the National Hospital Discharge Registry by a psychiatric clinic in 1978-82, were monitored for mortality during 1983 by using the National Cause of Death Registry. The study group consisted of 91 385 men and 77 217 women. The patients were divided into nine diagnostic groups according to the principal diagnosis registered at the latest discharge. Actuarial mathematics was used to construct life expectancy tables, which present the number of years expected to live, by gender and diagnostic group. Expectancies of life were significantly shortened for both genders and in all nine diagnostic groups (with one exception). Mental disorders in general are life shortening. This fact should be recognised in community health when setting health priorities. It should also be addressed in curricula as well as in treatment and preventive programmes.
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Vanishing Hopes and Dreams: Which Comes First? Addictions or Problems.
Tomblin, Mary; Haring, Kathryn A.
This paper discusses the increasing number of teenagers who are dually diagnosed with both learning disabilities and substance abuse and are not receiving appropriate treatment to deal with their special needs. It reports the outcomes of a phenomenological analysis of six young adults who discussed their problems with drug and alcohol abuse,…
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Lu, Xinli; Zhao, Cuiying; Wang, Wei; Nie, Chenxi; Zhang, Yuqi; Zhao, Hongru; Chen, Suliang; Cui, Ze
2016-01-01
Since the first HIV-1 case in 1989, Hebei province has presented a clearly rising trend of HIV-1 prevalence, and HIV-1 genetic diversity has become the vital barrier to HIV prevention and control in this area. To obtain detailed information of HIV-1 spread in different populations and in different areas of Hebei, a cross-sectional HIV-1 molecular epidemiological investigation was performed across the province. Blood samples of 154 newly diagnosed HIV-1 individuals were collected from ten prefectures in Hebei using stratified sampling. Partial gag and env genes were amplified and sequenced. HIV-1 genotypes were identified by phylogenetic tree analyses. Among the 139 subjects genotyped, six HIV-1 subtypes were identified successfully, including subtype B (41.0 %), CRF01_AE (40.3 %), CRF07_BC (11.5 %), CRF08_BC (4.3 %), unique recombinant forms (URFs) (1.4 %) and subtype C (1.4 %). Subtype B was identified as the most frequent subtype. Two URF recombination patterns were the same as CRF01_AE/B. HIV-1 genotype distribution showed a significant statistical difference in different demographic characteristics, such as source (P 0.05). The differences in HIV-1 genotype distribution were closely associated with transmission routes. Particularly, all six subtype strains were found in heterosexuals, showing that HIV-1 has spread from the high-risk populations to the general populations in Hebei, China. In addition, CRF01_AE instead of subtype B has become the major strain of HIV-1 infection among homosexuals. Our study revealed HIV-1 evolution and genotype distribution by investigating newly diagnosed HIV-1 individuals in Hebei, China. This study provides important information to enhance the strategic plan for HIV prevention and control in China.
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Psychiatric Diagnoses in Individuals with Non-Syndromic Oral Clefts
DEFF Research Database (Denmark)
Pedersen, Dorthe Almind; Wehby, George L; Murray, Jeffrey C
2016-01-01
for 247,821 person-years, and 85,653 individuals without OC followed for 2,501,129 person-years. RESULTS: A total of 953 (11.1%) of the individuals with OC (9.6% for cleft lip (CL), 10.8% for cleft lip and palate (CLP) and 13.1% for cleft palate (CP)) and 8,117 (9.5%) in the comparison group had at least...... one psychiatric diagnosis. Cox proportional hazard regression model revealed that individuals with OC had significantly higher risk of a psychiatric diagnosis (hazard ratio (HR) = 1.19, 95% CI: 1.12-1.28). When examining cleft type, no difference was found for CL (HR = 1.03, 95% CI: 0.......90-1.17), but CLP was associated with a small increased risk (HR = 1.13, 95% CI: 1.01-1.26), whereas individuals with CP had the largest increased risk (HR = 1.45, 95% CI: 1.30-1.62). The largest differences were found in schizophrenia-like disorders, mental retardation and pervasive developmental disorders, but we...
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Blomdahl, Christina; Guregård, Suzanne; Rusner, Marie; Wijk, Helle
2018-05-14
This study investigated the effects of manual-based Phenomenological Art Therapy for individuals living with depression in addition to treatment as usual (PATd/TAU) compared with only treatment as usual (TAU) for individuals diagnosed with moderate to severe depression. 79 adults (men = 29.1%) were included in this randomized-controlled-trial (RCT), multicenter study in Sweden with an intention-to-treat design. Participants were randomized into either the PATd/TAU-group (n = 43) or TAU-group (n = 36). Data were collected at baseline and at end of treatment. The main outcomes were depression levels and self-esteem. Secondary outcomes were suicide ideation and sickness absence. The PATd/TAU-group showed a significant decrease of depression levels. The PATd/TAU-group returned to work to a higher degree than the TAU-group. Self-esteem significantly improved in both groups. Suicide ideation was unaffected. Manual-based PATd works as expected, being an effective treatment, and contributes to recovery for individuals with moderate to severe depression. This outcome needs to be confirmed and its long-term effects examined in further studies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Petrakis, Ismene L; Rosenheck, Robert; Desai, Rani
2011-01-01
There is considerable concern about the emergence of significant substance abuse among younger veterans of war in the Middle East, especially among those with Posttraumatic Stress Disorder (PTSD), but little information exists on the magnitude of this problem. Using national administrative data from the Department of Veterans Affairs (VA) (n = 1,001,996), we examined rates of diagnosed substance use disorders in Veterans who served in Iraq and Afghanistan diagnosed with PTSD compared to other psychiatric disorders; and compared rates among veterans of other service eras. Of VA patients with a selected mental disorder, 21.0% had a comorbid substance diagnosis. Veterans who served in the post-Vietnam era (VET) (1973-1991) had the highest rates of comorbidity. Logistic regression models indicated that veterans with each selected psychiatric diagnosis were significantly more likely to be dually diagnosed in comparison to veterans with PTSD; post-Vietnam veterans were significantly more likely to be dually diagnosed than veterans from other eras. Bipolar disorder and schizophrenia are most strongly associated with dual diagnosis in OEF/OIF (Operation Enduring Freedom/Operation Iraqi Freedom) veterans. There are high rates of substance use disorders among veterans with mental illness. The highest rates of comorbidity occur among those with bipolar disorder and schizophrenia; and in post-VET veterans. © American Academy of Addiction Psychiatry.
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Arias, Francisco; Szerman, Nestor; Vega, Pablo; Mesías, Beatriz; Basurte, Ignacio; Rentero, David
2017-06-28
Given its prevalence and impact on public health, the comorbidity of bipolar and substance use disorders is one of the most relevant of dual diagnoses. The objective was to evaluate the characteristics of patients from community mental health and substance abuse centres in Madrid. The sample consisted of 837 outpatients from mental health and substance abuse centres. We used the Mini International Neuropsychiatric Interview (MINI) and Personality Disorder Questionnaire (PDQ4+) to evaluate axis I and II disorders. Of these patients, 174 had a lifetime bipolar disorder, 83 had bipolar disorder type I and 91 had type II. Most patients had dual pathology. Of the 208 participants from the mental health centres, 21 had bipolar disorder and 13 (61.9%) were considered dually-diagnosed patients, while 33.2% of non-bipolar patients had a dual diagnoses (p = 0.03). Of the 629 participants from the substance abuse centres, 153 patients (24.3%) had a bipolar diagnosis. Bipolar dual patients had higher rates of alcohol and cocaine dependence than non-bipolar patients. Moreover, age at onset of alcohol use was earlier in bipolar duallydiagnosed patients than in other alcoholics. Bipolar dually-diagnosed patients had higher personality and anxiety disorder comorbidities and greater suicide risk. Thus, alcohol and cocaine are the drugs most associated with bipolar disorder. Given the nature of the study, the type of relationship between these disorders cannot be determined.
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Bukowski, Leigh A; Blosnich, John; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Gordon, Adam J
2017-09-01
Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses. This study used a retrospective review of The Department of Veterans Affairs (VA) administrative data for transgender patients who received VA care from 1997 through 2014. Transgender patients were defined as individuals that had a lifetime diagnosis of any of 4 International Classification of Diseases-9 diagnosis codes associated with transgender status. Independent multivariable logistic regression models were used to explore associations of rural status with medical conditions. Veterans with transgender-related diagnoses residing in small/isolated rural towns had increased odds of tobacco use disorder (adjusted odds ratio=1.39; 95% confidence intervals, 1.09-1.78) and posttraumatic stress disorder (adjusted odds ratio=1.33; 95% confidence intervals, 1.03-1.71) compared with their urban transgender peers. Urban/rural status was not significantly associated with other medical conditions of interest. This study contributes the first empirical investigations of how place of residence is associated with medical diagnoses among veterans with transgender-related diagnoses. The importance of place as a determinant of health is increasingly clear, but for veterans with transgender-related diagnoses this line of research is currently limited. The addition of self-reported sex identity data within VA electronic health records is one way to advance this line of research.
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AA Attendance and Abstinence for Dually Diagnosed Patients: A Meta-Analytic Review.
Scott Tonigan, J; Pearson, Matthew R; Magill, Molly; Hagler, Kylee J
2018-05-29
There is consensus that best clinical practice for dual diagnosis (DD) is integrated mental health and substance use treatment augmented with Alcoholics Anonymous (AA) attendance. This is the first quantitative review of the direction and magnitude of the association between AA attendance and alcohol abstinence for DD patients. A systematic literature search (1993-2017) identified 22 studies yielding 24 effect sizes that met our inclusion criteria (8,075 patients). Inverse-variance weighting of correlation coefficients (r) was used to aggregate sample-level findings and study aims were addressed using random and mixed effect models. Sensitivity and publication bias analyses were conducted to assess the likelihood of bias in the overall estimate of AA-related benefit. AA exposure and abstinence for DD patients were significantly and positively associated (r w =.249; 95% CI.203-.293; Tau=.097). There was also significant heterogeneity in the distribution of effect sizes, (Q(23)=90.714, pAA-related benefit did not differ between 6 (k=7) and 12 (k=12) month follow-up, (Q=.068, pAA benefit was not adversely or substantively impacted by pooling RCT and observational samples (Q=.763, pAA (Q=.023, pAA) is common and, in many cases, DD patients who attend AA will report higher rates of alcohol abstinence relative to DD patients who do not attend AA. This article is protected by copyright. All rights reserved.
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Use of bayesian operations for diagnosing accidents
International Nuclear Information System (INIS)
Kang, K.M.; Jae, M.; Suh, K.Y.
2005-01-01
In complex systems, it is necessary to model a logical representation of the overall system interaction with respect to the individual subsystems. Operators are allowed to follow EOPs (Emergency Operating Procedures) when reactor tripped because of accidents. But, it's very difficult to diagnose accidents and find out appropriate procedures to mitigate current accidents in a given short time. Even if they diagnose accidents, it also has possibility to misdiagnose. TMI accident is a good example of operators' errors. Methodology using Influence Diagrams has been developed and applied for representing the dependency behaviors and uncertain behaviors of complex systems. An example to diagnose the accidents such as SLOCA and SGTR with similar symptoms has been introduced. From the constructed model, operators could diagnose accidents at any states of accidents. This model can offer the information about accidents with given symptoms. This model might help operators to diagnose correctly and rapidly. It might be very useful to support operators to reduce human error. Also, from this study, it is applicable to diagnose other accidents with similar symptoms and to analyze causes of reactor trip. (authors)
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Myers, Lorna; Vaidya-Mathur, Urmi; Lancman, Marcelo
2017-01-01
Although there is general consensus that psychogenic non-epileptic seizures (PNES) are treated with psychotherapy, the effectiveness of most psychotherapeutic modalities remains understudied. In this treatment series of 16 patients dually diagnosed with PNES and post-traumatic stress disorder (PTSD), we evaluated the effect of prolonged exposure therapy (PE) on reduction of PNES. Secondary measures included Beck Depression Inventory (BDI-II) and Post-Traumatic Disorder Diagnostic Scale (PDS). Subjects diagnosed with video EEG-confirmed PNES and PTSD confirmed through neuropsychological testing and clinical interview were treated with traditional PE psychotherapy with certain modifications for the PNES. Treatment was conducted over the course of 12-15 weekly sessions. Seizure frequency was noted in each session by examining the patients' seizure logs, and mood and PTSD symptomatology was assessed at baseline and on the final session. Eighteen subjects enrolled, and 16 (88.8%) completed the course of treatment. Thirteen of the 16 (81.25%) therapy completers reported no seizures by their final PE session, and the other three reported a decline in seizure frequency (Z=-3.233, p=0.001). Mean scores on scales of depression (M=-13.56, SD=12.27; t (15)=-4.420, pPTSD symptoms (M=-17.1875, SD=13.01; t (15)=-5.281, pPTSD reduced the number of PNES and improved mood and post traumatic symptomatology. Follow-up revealed that gains made in seizure control on the last day of treatment were maintained over time. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
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Norfolk, Tim; Siriwardena, A Niroshan
2013-01-01
This discussion paper describes a new and comprehensive model for diagnosing the causes of individual medical performance problems: SKIPE (skills, knowledge, internal, past and external factors). This builds on a previous paper describing a unifying theory of clinical practice, the RDM-p model, which captures the primary skill sets required for effective medical performance (relationship, diagnostics and management), and the professionalism that needs to underpin them. The SKIPE model is currently being used, in conjunction with the RDM-p model, for the in-depth assessment and management of doctors whose performance is a cause for concern.
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Friberg, Emilie; Rosenhall, Ulf; Alexanderson, Kristina
2014-02-08
It is estimated that hearing difficulties will be one of the top ten leading burdens of disease by 2030. Knowledge of mortality among individuals on sick leave or disability pension due to hearing diagnoses is virtually non-existent. We aimed prospectively to examine the associations of diagnosis-specific sick leave and disability pension due to different otoaudiological diagnoses with risks of all-cause and cause-specific mortality. A cohort, based on Swedish registry data, including all 5,248,672 individuals living in Sweden in 2005, aged 20-64, and not on old-age pension, was followed through 2010. Otoaudiological diagnoses were placed in the following categories: otological, hearing, vertigo, and tinnitus. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models; individuals on sick leave or disability pension due to different otoaudiological diagnoses during 2005 were compared with those not on sick leave or disability pension. In multivariable models, individuals with sickness absence due to otoaudiological diagnoses showed a lower risk of mortality, while individuals on disability pension due to otoaudiological diagnoses showed a 14% (95% CI 1-29%) increased risk of mortality, compared with individuals not on sick leave or disability pension. The risk increase among individuals on disability pension was largely attributable to otological (HR 1.56; 95% CI = 1.04-2.33) and hearing diagnoses (HR 1.20; 95% CI = 1.00-1.43). This large nationwide population-based cohort study suggests an increased risk of mortality among individuals on disability pension due to otoaudiological diagnoses.
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Depression diagnoses following the identification of bipolar disorder: costly incongruent diagnoses
Directory of Open Access Journals (Sweden)
Schultz Jennifer F
2010-06-01
Full Text Available Abstract Background Previous research has documented that the symptoms of bipolar disorder are often mistaken for unipolar depression prior to a patient's first bipolar diagnosis. The assumption has been that once a patient receives a bipolar diagnosis they will no longer be given a misdiagnosis of depression. The objectives of this study were 1 to assess the rate of subsequent unipolar depression diagnosis in individuals with a history of bipolar disorder and 2 to assess the increased cost associated with this potential misdiagnosis. Methods This study utilized a retrospective cohort design using administrative claims data from 2002 and 2003. Patient inclusion criteria for the study were 1 at least 2 bipolar diagnoses in 2002, 2 continuous enrollment during 2002 and 2003, 3 a pharmacy benefit, and 4 age 18 to 64. Patients with at least 2 unipolar depression diagnoses in 2003 were categorized as having an incongruent diagnosis of unipolar depression. We used propensity scoring to control for selection bias. Utilization was evaluated using negative binomial models. We evaluated cost differences between patient cohorts using generalized linear models. Results Of the 7981 patients who met all inclusion criteria for the analysis, 17.5% (1400 had an incongruent depression diagnosis (IDD. After controlling for background differences, individuals who received an IDD had higher rates of inpatient and outpatient psychiatric utilization and cost, on average, an additional $1641 per year compared to individuals without an IDD. Conclusions A strikingly high proportion of bipolar patients are given the differential diagnosis of unipolar depression after being identified as having bipolar disorder. Individuals with an IDD had increased acute psychiatric care services, suggesting higher levels of relapses, and were at risk for inappropriate treatment, as antidepressant therapy without a concomitant mood-stabilizing medication is contraindicated in bipolar
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[Community pneumonia - fundamentals of diagnosing and treatment].
Kolek, Vítězslav
Pneumonia is the most serious respiratory disease which causes more than 3 000 deaths per year in the Czech Republic. Community-acquired pneumonia is contracted in the ordinary life environment outside of hospitals, its development is caused by known infectious agents which mostly exhibit satisfactory sensitivity to antibiotics. Diagnosing, prevention and treatment of the disease are described including considerations of individual evaluation of the risk of complications and possible death. The strategy of administering antibiotics is discussed.Key words: antibiotics - community-acquired pneumonias - diagnosing - treatment.
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Ward, Martha C; Lally, Cathy; Druss, Benjamin G
2017-01-01
Medicaid is an important funder of care for individuals with behavioral (psychiatric and/or substance use) diagnoses, and expenditures will likely increase with expansion of services under the Affordable Care Act. This study provides national estimates of Medicaid expenditures using a comprehensive sample of fee-for-service Medicaid enrollees with behavioral diagnoses. Data for analysis came from 2003 to 2004 Medicaid Analytic eXtract (MAX) files for 50 states and the District of Columbia. Individuals with behavioral diagnoses had high rates of chronic medical comorbidities, and expenditures for medical (non-behavioral) diagnoses accounted for 74 % of their health care expenditures. Total Medicaid expenditure was approximately 15 billion dollars (equivalent to 18.91 billion in 2016 dollars) for individuals with any behavioral diagnosis. Medicaid fee-for-service beneficiaries with behavioral diagnoses have a high treated prevalence of individual medical comorbid conditions, and the majority of health care expenditures in these individuals are for medical, rather than behavioral health, services.
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Nemr, Katia; Cota, Ariane; Tsuji, Domingos; Simões-Zenari, Marcia
2018-01-01
OBJECTIVES: To characterize the voice quality of individuals with dysphonia and to investigate possible correlations between the degree of voice deviation (D) and scores on the Dysphonia Risk Screening Protocol-General (DRSP), the Voice-Related Quality of Life (V-RQOL) measure and the Voice Handicap Index, short version (VHI-10). METHODS: The sample included 200 individuals with dysphonia. Following laryngoscopy, the participants completed the DRSP, the V-RQOL measure, and the VHI-10; subsequently, voice samples were recorded for auditory-perceptual and acoustic analyses. The correlation between the score for each questionnaire and the overall degree of vocal deviation was analyzed, as was the correlation among the scores for the three questionnaires. RESULTS: Most of the participants (62%) were female, and the mean age of the sample was 49 years. The most common laryngeal diagnosis was organic dysphonia (79.5%). The mean D was 59.54, and the predominance of roughness had a mean of 54.74. All the participants exhibited at least one abnormal acoustic aspect. The mean questionnaire scores were DRSP, 44.7; V-RQOL, 57.1; and VHI-10, 16. An inverse correlation was found between the V-RQOL score and D; however, a positive correlation was found between both the VHI-10 and DRSP scores and D. CONCLUSION: A predominance of adult women, organic dysphonia, moderate voice deviation, high dysphonia risk, and low to moderate quality of life impact characterized our sample. There were correlations between the scores of each of the three questionnaires and the degree of voice deviation. It should be noted that the DRSP monitored the degree of dysphonia severity, which reinforces its applicability for patients with different laryngeal diagnoses. PMID:29538494
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DEFF Research Database (Denmark)
Nottelmann, Lise; Groenvold, Mogens; Vejlgaard, Tove Bahn
2017-01-01
BACKGROUND: The effect of early palliative care and rehabilitation on the quality of life of patients with advanced cancer has been only sparsely described and needs further investigation. In the present trial we combine elements of early, specialized palliative care with cancer rehabilitation...... in a 12-week individually tailored, palliative rehabilitation program initiated shortly after a diagnosis of advanced cancer. METHODS: This single center, randomized, controlled trial will include 300 patients with newly diagnosed advanced cancer recruited from the Department of Oncology, Vejle Hospital...... initiated shortly after an advanced cancer diagnosis. The study will contribute with evidence on the effectiveness of implementing early palliative care in standard oncology treatment and hopefully offer new knowledge and future directions as to the content of palliative rehabilitation programs. TRIAL...
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2014-01-01
Background It is estimated that hearing difficulties will be one of the top ten leading burdens of disease by 2030. Knowledge of mortality among individuals on sick leave or disability pension due to hearing diagnoses is virtually non-existent. We aimed prospectively to examine the associations of diagnosis-specific sick leave and disability pension due to different otoaudiological diagnoses with risks of all-cause and cause-specific mortality. Methods A cohort, based on Swedish registry data, including all 5 248 672 individuals living in Sweden in 2005, aged 20–64, and not on old-age pension, was followed through 2010. Otoaudiological diagnoses were placed in the following categories: otological, hearing, vertigo, and tinnitus. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models; individuals on sick leave or disability pension due to different otoaudiological diagnoses during 2005 were compared with those not on sick leave or disability pension. Results In multivariable models, individuals with sickness absence due to otoaudiological diagnoses showed a lower risk of mortality, while individuals on disability pension due to otoaudiological diagnoses showed a 14% (95% CI 1-29%) increased risk of mortality, compared with individuals not on sick leave or disability pension. The risk increase among individuals on disability pension was largely attributable to otological (HR 1.56; 95% CI = 1.04-2.33) and hearing diagnoses (HR 1.20; 95% CI = 1.00-1.43). Conclusion This large nationwide population-based cohort study suggests an increased risk of mortality among individuals on disability pension due to otoaudiological diagnoses. PMID:24507477
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Directory of Open Access Journals (Sweden)
Dubinsky A.A.
2017-01-01
Full Text Available The relationship between individual psychological and individually-typological characteristics of patients with personality disorders who committed socially dangerous acts were studied, taking into account the severity of the organic factor and the degree of their social dangerousness. 121 males were surveyed, 70 of them were diagnosed with "organic personality disorder" and 33 - personality disorder. The types of personality disorders were diagnosed. The individual variables, the ratio of processes of system activation of behavior and its inhibition, protective styles, especially coping behaviours that constitute aggression, styles of self-regulation were analyzed. It was revealed that low settings of the system activation behavior found in the group of persons with a high degree of social dangerousness, determines the formation of individual psychological treats related to the rigidity behavior, the instability of the motives, impulsivity, negative emotionality, disinhibition. During comparison of samples of individuals with medium and high degree of social dangerousness it has been discovered that self-centeredness, as a component of self-control, high levels of affective components of aggression – anger and immature defense mechanisms significantly distinguish individuals with a high degree of public danger.
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Musliner, K L; Østergaard, S D
2018-05-01
Conversion from unipolar depression (UD) to bipolar disorder (BD) is a clinically important event that should lead to treatment modifications. Unfortunately, recognition of this transition is often delayed. Therefore, the objective of this study was to identify predictors of diagnostic conversion from UD to BD. Historical prospective cohort study based on 91 587 individuals diagnosed with UD in Danish hospital psychiatry between 1995 and 2016. The association between a series of potential predictors and the conversion from UD to BD during follow-up (702 710 person-years) was estimated by means of Cox regression with death as competing risk. During follow-up, 3910 individuals with UD developed BD. The cumulative incidence of conversion was slightly higher in females (8.7%, 95% CI: 8.2-9.3) compared to males (7.7%, 95% CI: 7.0-8.4). The strongest predictor of conversion from UD to BD was parental history of BD (adjusted hazard ratio (aHR) = 2.60, 95% CI: 2.20-3.07)). Other predictors included psychotic depression at the index UD episode (aHR = 1.73, 95% CI: 1.48-2.02), a prior/concomitant non-affective psychosis (aHR = 1.73, 95% CI: 1.51-1.99), and in-patient treatment at the index episode (aHR = 1.76, 95% CI: 1.63-1.91). Diagnostic conversion from UD to BD is predicted by severe depression requiring in-patient treatment, psychotic symptomatology, and parental history of BD. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Szerman Bolotner, Néstor; Arias Horcajadas, Francisco; Vega Astudillo, Pablo; Babín Vich, Francisco; Mesías Perez, Beatriz; Basurte Villamor, Ignacio; Morant, Consuelo; Ochoa Mangado, Enriqueta; Poyo Calvo, Félix
2011-01-01
To evaluate retrospectively the comorbidity of mental and addictive disorders in community mental health and substance misuse services in Madrid. The medical records of 400 patients from mental health and substance misuse services in Madrid were evaluated. Records were examined for the last 20 patients from each service unit. Dual pathology was constituted when a current diagnosis of mental and addictive disorders, excluding nicotine addiction, appeared on the patient's records. Prevalence of dual pathology was 34%. There were differences in the prevalence figures for the two kinds of service: 36.78% in substance misuse services, and 28.78% in mental health services. There was an association of dual diagnosis with alcohol or cocaine dependence, but not with opioid dependence. The mental disorders more prevalent in dually diagnosed than in non-dually diagnosed patients were mood disorders, personality disorders, and schizophrenia. There is a high prevalence of dual pathology in those seeking treatment, being higher in substance misuse services than in mental health services, and higher in patients with alcohol or cocaine dependence. These findings could be of help in the planning of care resource policies for these patients.
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Lee, Amy; Kiemle, Gundi
2015-01-01
Background: This study examines the experiences of qualified nurses working with individuals diagnosed with both intellectual disability and personality disorder (PD) in a medium-secure forensic intellectual disability setting. Potential training needs are highlighted, as well as other ways in which services could better support staff to work…
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Sosenko, Jay M; Skyler, Jay S; DiMeglio, Linda A; Beam, Craig A; Krischer, Jeffrey P; Greenbaum, Carla J; Boulware, David; Rafkin, Lisa E; Matheson, Della; Herold, Kevan C; Mahon, Jeffrey; Palmer, Jerry P
2015-02-01
We assessed whether type 1 diabetes (T1D) can be diagnosed earlier using a new approach based on prediction and natural history in autoantibody-positive individuals. Diabetes Prevention Trial-Type 1 (DPT-1) and TrialNet Natural History Study (TNNHS) participants were studied. A metabolic index, the T1D Diagnostic Index60 (Index60), was developed from 2-h oral glucose tolerance tests (OGTTs) using the log fasting C-peptide, 60-min C-peptide, and 60-min glucose. OGTTs with Index60 ≥2.00 and 2-h glucose <200 mg/dL (Ind60+Only) were compared with Index60 <2.00 and 2-h glucose ≥200 mg/dL (2hglu+Only) OGTTs as criteria for T1D. Individuals were assessed for C-peptide loss from the first Ind60+Only OGTT to diagnosis. Areas under receiver operating characteristic curves were significantly higher for Index60 than for the 2-h glucose (P < 0.001 for both DPT-1 and the TNNHS). As a diagnostic criterion, sensitivity was higher for Ind60+Only than for 2hglu+Only (0.44 vs. 0.15 in DPT-1; 0.26 vs. 0.17 in the TNNHS) OGTTs. Specificity was somewhat higher for 2hglu+Only OGTTs in DPT-1 (0.97 vs. 0.91) but equivalent in the TNNHS (0.98 for both). Positive and negative predictive values were higher for Ind60+Only OGTTs in both studies. Postchallenge C-peptide levels declined significantly at each OGTT time point from the first Ind60+Only OGTT to the time of standard diagnosis (range -22 to -34% in DPT-1 and -14 to -27% in the TNNHS). C-peptide and glucose patterns differed markedly between Ind60+Only and 2hglu+Only OGTTs. An approach based on prediction and natural history appears to have utility for diagnosing T1D. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
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Five cases of neurocysticercosis diagnosed in Sydney.
Walker, J; Chen, S; Packham, D; McIntyre, P
1991-12-01
Cysticercosis, once rare in Australia, is now more frequently diagnosed. This change reflects the countries of origin of new immigrants and the destinations of Australians travelling. Five cases of neurocysticercosis diagnosed at Westmead Hospital in Sydney are described. Two involved Australians, a father and son who had visited eastern and southeastern Asia 10 years before presentation. The other three included immigrants from Chile and India and a visitor from Timor. Ages ranged from 5 to 57 years. Three individuals presented after focal seizures involving the upper limb, one had a long standing history of neurological dysfunction and one suffered from persistent headaches. In all cases computed tomographic scanning (CT) or magnetic resonance imaging (MRI) revealed cystic brain lesions and three of the five were seropositive as well. Four were treated with praziquantel and in one the lesions regressed significantly following treatment. However, the lesion in one case had decreased in size prior to treatment and that in the untreated individual also became smaller.
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Evidence of a reduction over time in the behavioral severity of autistic disorder diagnoses.
Whitehouse, Andrew J O; Cooper, Matthew N; Bebbington, Keely; Alvares, Gail; Lin, Ashleigh; Wray, John; Glasson, Emma J
2017-01-01
The increasing prevalence of Autism Spectrum Disorders (ASD) may in part be due to a shift in the diagnostic threshold that has led to individuals with a less severe behavioral phenotype receiving a clinical diagnosis. This study examined whether there were changes over time in the qualitative and quantitative phenotype of individuals who received the diagnosis of Autistic Disorder. Data were from a prospective register of new diagnoses in Western Australia (n = 1252). From 2000 to 2006, we examined differences in both the percentage of newly diagnosed cases that met each criterion as well as severity ratings of the behaviors observed (not met, partially met, mild/moderate and extreme). Linear regression determined there was a statistically significant reduction from 2000 to 2006 in the percentage of new diagnoses meeting two of 12 criteria. There was also a reduction across the study period in the proportion of new cases rated as having extreme severity on six criteria. There was a reduction in the proportion of individuals with three or more criteria rated as extreme from 2000 (16.0%) to 2006 (1.6%), while percentage of new cases with no "extreme" rating on any criteria increased from 58.5% to 86.6% across the same period. This study provides the first clear evidence of a reduction over time in the behavioral severity of individuals diagnosed with Autistic Disorder during a period of stability in diagnostic criteria. A shift toward diagnosing individuals with less severe behavioral symptoms may have contributed to the increasing prevalence of Autistic Disorder diagnoses. Autism Res 2017, 10: 179-187. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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International Nuclear Information System (INIS)
Ding, Caihua; Zhao, Yongjie; Yan, Dong; Su, Dezhi; Zhao, Yuzhen; Zhou, Heping; Li, Jingbo; Jin, Haibo
2017-01-01
Application products moving from small-sized devices to large-scale energy storage systems have pushed the development of lithium-ion batteries towards high-energy densities, high-power densities, and long cycle life. Germanium-based anode materials with high theoretical capacities are expected as promising anode candidates to fulfill those requirements, but suffer from the huge volume expansion upon lithiation, leading to serious material pulverization and capacity fading. Herein, a convenient and cost-effective strategy was conceived focusing on construction of dually-protected Zn 2 GeO 4 /graphene composites. The rationally designed composite was composed of hollowed Zn 2 GeO 4 nanostructures and flexible graphene layers, which acted as two functional nanoframes to synergistically alleviate the volume change during lithiation/delithiation. As a result, the Zn 2 GeO 4 /graphene composite exhibited high specific capacities, excellent cycling stability and desirable rate capability. Specifically, the Zn 2 GeO 4 /graphene composite electrode delivered specific capacity of 702 mA h g −1 at 300 mA g −1 after 600 cycles with capacity retention of 85%. In addition, a high reversible capacity of 600 mA h g −1 was retained over 1000 cycles at a high current density of 800 mA g −1 . Those achieved-results suggested that rational design of electrode nanostructures offers an effective insight for obtaining high-performance batteries.
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Directory of Open Access Journals (Sweden)
Priscila Camara de Moura
2015-02-01
Full Text Available This study aimed to identify the most prevalent nursing diagnoses in hypertensive and diabetic patients in the Family Health Care Unit, according to Orem’s conceptual model. A descriptive study was conducted from April to November 2013, using a nursing assessment based on Orem’s theory and NANDA-I taxonomy. 16 nursing diagnoses were identified on Universal self-care requisites, nine on Health deviation requisites and two on Developmental self-care requisites, the most prevalent being: “Risk for unstable blood glucose level” (60%, “Ineffective self-care management” (50% and “Disposition for improved knowledge” (36.6%. Teaching (83.3% and support/instruction (100% actions were implemented in nursing care planning. It can be concluded that there is a need to implement nursing activities directed to offering education on Family Health practices.
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Di Biase, M A; Zalesky, A; O'keefe, G; Laskaris, L; Baune, B T; Weickert, C S; Olver, J; McGorry, P D; Amminger, G P; Nelson, B; Scott, A M; Hickie, I; Banati, R; Turkheimer, F; Yaqub, M; Everall, I P; Pantelis, C; Cropley, V
2017-08-29
We examined putative microglial activation as a function of illness course in schizophrenia. Microglial activity was quantified using [ 11 C](R)-(1-[2-chrorophynyl]-N-methyl-N-[1-methylpropyl]-3 isoquinoline carboxamide ( 11 C-(R)-PK11195) positron emission tomography (PET) in: (i) 10 individuals at ultra-high risk (UHR) of psychosis; (ii) 18 patients recently diagnosed with schizophrenia; (iii) 15 patients chronically ill with schizophrenia; and, (iv) 27 age-matched healthy controls. Regional-binding potential (BP ND ) was calculated using the simplified reference-tissue model with four alternative reference inputs. The UHR, recent-onset and chronic patient groups were compared to age-matched healthy control groups to examine between-group BP ND differences in 6 regions: dorsal frontal, orbital frontal, anterior cingulate, medial temporal, thalamus and insula. Correlation analysis tested for BP ND associations with gray matter volume, peripheral cytokines and clinical variables. The null hypothesis of equality in BP ND between patients (UHR, recent-onset and chronic) and respective healthy control groups (younger and older) was not rejected for any group comparison or region. Across all subjects, BP ND was positively correlated to age in the thalamus (r=0.43, P=0.008, false discovery rate). No correlations with regional gray matter, peripheral cytokine levels or clinical symptoms were detected. We therefore found no evidence of microglial activation in groups of individuals at high risk, recently diagnosed or chronically ill with schizophrenia. While the possibility of 11 C-(R)-PK11195-binding differences in certain patient subgroups remains, the patient cohorts in our study, who also displayed normal peripheral cytokine profiles, do not substantiate the assumption of microglial activation in schizophrenia as a regular and defining feature, as measured by 11 C-(R)-PK11195 BP ND .
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Matrix Analysis of Traditional Chinese Medicine Differential Diagnoses in Gulf War Illness.
Taylor-Swanson, Lisa; Chang, Joe; Schnyer, Rosa; Hsu, Kai-Yin; Schmitt, Beth Ann; Conboy, Lisa A
2018-03-08
To qualitatively categorize Traditional Chinese Medicine (TCM) differential diagnoses in a sample of veterans with Gulf War Illness (GWI) pre- and postacupuncture treatment. The authors randomized 104 veterans diagnosed with GWI to a 6-month acupuncture intervention that consisted of either weekly or biweekly individualized acupuncture treatments. TCM differential diagnoses were recorded at baseline and at 6 months. These TCM diagnoses were evaluated using Matrix Analysis to determine co-occurring patterns of excess, deficiency, and channel imbalances. These diagnoses were examined within and between participants to determine patterns of change and to assess stability of TCM diagnoses over time. Frequencies of diagnoses of excess, deficiency, and channel patterns were tabulated. Diagnoses of excess combined with deficiency decreased from 43% at baseline to 39% of the sample at 6 months. Excess+deficiency+channel imbalances decreased from 26% to 17%, while deficiency+channel imbalances decreased from 11% to 4% over the study duration. The authors observed a trend over time of decreased numbers of individuals presenting with all three types of differential diagnosis combinations. This may suggest that fewer people were diagnosed with concurrent excess, deficiency, and channel imbalances and perhaps a lessening in the complexity of their presentation. This is the first published article that organizes and defines TCM differential diagnoses using Matrix Analysis; currently, there are no TCM frameworks for GWI. These findings are preliminary given the sample size and the amount of missing data at 6 months. Characterization of the TCM clinical presentation of veterans suffering from GWI may help us better understand the potential role that East Asian medicine may play in managing veterans with GWI and the design of effective acupuncture treatments based on TCM. The development of a TCM manual for treating GWI is merited.
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Effects of acid-hydrolysis and hydroxypropylation on functional properties of sago starch.
Fouladi, Elham; Mohammadi Nafchi, Abdorreza
2014-07-01
In this study, sago starch was hydrolyzed by 0.14M HCl for 6, 12, 18, and 24h, and then modified by propylene oxide at a concentration of 0-30% (v/w). The effects of hydrolysis and etherification on molecular weight distribution, physicochemical, rheological, and thermal properties of dually modified starch were estimated. Acid hydrolysis of starch decreased the molecular weight of starch especially amylopectin, but hydroxypropylation had no effect on the molecular weight distribution. The degree of Molar substitution (DS) of hydroxypropylated starch after acid hydrolysis ranged from 0.007 to 0.15. Dually modified starch with a DS higher than 0.1 was completely soluble in cold water at up to 25% concentration of the starch. This study shows that hydroxypropylation and hydrolysis have synergistic effects unlike individual modifications. Dually modified sago starch can be applied to dip-molding for food and pharmaceutical processing because of its high solubility and low tendency for retrogradation. Copyright © 2014 Elsevier B.V. All rights reserved.
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Beyond Symptom Counts for Diagnosing Oppositional Defiant Disorder and Conduct Disorder?
Lindhiem, Oliver; Bennett, Charles B; Hipwell, Alison E; Pardini, Dustin A
2015-10-01
Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD) are among the most commonly diagnosed childhood behavioral health disorders. Although there is substantial evidence of heterogeneity of symptom presentations, DSM diagnoses of CD and ODD are formally diagnosed on the basis of symptom counts without regard to individual symptom patterns. We used unidimensional item response theory (IRT) two-parameter logistic (2PL) models to examine item parameters for the individual symptoms of CD and ODD using data on 6,491 adolescents (ages 13-17) from the National Comorbidity Study: Adolescent Supplement (NCS-A). For each disorder, the symptoms differed in terms of severity and discrimination parameters. As a result, some adolescents who were above DSM diagnostic thresholds for disruptive behavior disorders exhibited lower levels of the underlying construct than others below the thresholds, based on their unique symptom profile. In terms of incremental benefit, our results suggested an advantage of latent trait scores for CD but not ODD.
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DEFF Research Database (Denmark)
Jørgensen, Terese Sara Høj; Torp-Pedersen, Christian; Gislason, Gunnar H
2015-01-01
BACKGROUND: Centralization of specialized health care in Denmark has caused increased geographical distance to health-care providers, which may be a barrier for Alzheimer patients to seek health care. We examined the incidence of Alzheimer diagnosis in Denmark between 2000 and 2009 and investigated...... the association between patients' distance to Alzheimer clinics and Alzheimer diagnoses. METHODS: Data of all individuals aged 65+ years were collected from Danish national registers. Incidences of Alzheimer diagnoses were analysed with joinpoint regression and hazard ratios (HRs) for Alzheimer diagnoses were...... analysed with Cox regressions. RESULTS: The annual incidence of Alzheimer diagnoses increased with 32.5% [95% confidence interval (CI): 7.1-63.8] among individuals aged 65-74 years from 2000 to 2002 and with 29.1% (95% CI: 11.0-50.2) among individuals aged 75+ years from 2000 to 2003. For both groups...
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Bourry, Olivier; Fablet, Christelle; Simon, Gaëlle; Marois-Créhan, Corinne
2015-11-18
Porcine respiratory disease complex (PRDC) is one of the main causes of economic losses for swine producers. This complex is due to a combination of different pathogens and their interactions. Two major pathogens involved in PRDC are Mycoplasma hyopneumoniae (Mhp) and porcine reproductive and respiratory syndrome virus (PRRSV). The objectives of this study were (i) to develop an experimental model of dual Mhp/PRRSV infection in SPF pigs with European strains of Mhp and PRRSV and (ii) to assess and compare the effects of single Mhp, single PRRSV or combined Mhp/PRRSV vaccination against this dual infection. Pigs dually infected with Mhp and PRRSV showed a combination of symptoms characteristic of each pathogen but no significant exacerbation of pathogenicity. Thus, the co-infected pigs displayed coughing and pneumonia typical of Mhp infection in addition to PRRSV-related hyperthermia and decrease in average daily gain (ADG). Hyperthermia was reduced in PRRSV vaccinated animals (single or combined vaccination), whereas ADG was restored in Mhp/PRRSV vaccinated pigs only. Regarding respiratory symptoms and lung lesions, no vaccine decreased coughing. However, all vaccines reduced the pneumonia score but more so in animals receiving the Mhp vaccine, whether single or combined. This vaccine also decreased the Mhp load in the respiratory tract. In conclusion, combined vaccination against both Mhp and PRRSV efficiently pooled the efficacy of each single PRRSV and Mhp vaccination and could be an interesting tool to control PRDC in European swine production. Copyright © 2015 Elsevier B.V. All rights reserved.
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Nargiso, Jessica E.; Kuo, Caroline C.; Zlotnick, Caron; Johnson, Jennifer E.
2014-01-01
The nature of social support available to incarcerated women is not well understood, particularly among women at high risk of negative outcomes, including women dually-diagnosed with Major Depressive Disorder and a Substance Use Disorder (MDD-SUD). Descriptive statistics and paired-tests were conducted on 60 incarcerated MDD-SUD women receiving in-prison substance use and depression treatments to characterize the women’s social networks, including the strength of support, network characterist...
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CD4 cell count recovery in HIV/TB co-infected patients versus TB uninfected HIV patients
Directory of Open Access Journals (Sweden)
Wanchu A
2010-10-01
Full Text Available Background: There is lack of data comparing the improvement in CD4 count following antitubercular (ATT and antiretroviral therapy (ART in patients presenting with Human Immunodeficiency Virus/Tuberculosis (HIV/TB dual infection compared with CD4 matched cohort of TB uninfected HIV patients initiated on ART. We sought to test the hypothesis; TB additionally contributes to reduction in CD4 count in HIV/TB co-infected patients and this would result in greater improvement in count following treatment compared with CD4 matched TB uninfected individuals. Materials and Methods: In a retrospective cohort study design we studied the change in CD4 cell counts in two groups of patients - those with CD4 cell count >100 cells / mm 3 (Group 1 and <100/mm 3 (Group 2 at presentation. In each group the change in CD4 cell count in dually infected patients following six-month ATT and ART was compared to cohorts of CD4 matched TB uninfected patients initiated on ART. Results: In Group 1 (52 patients dually infected subjects′ CD4 count improved from 150 cells/ mm 3 to 345 cells/mm 3 (P=0.001. In the control TB uninfected patients, the change was from 159 cells/mm 3 to 317 cells/mm 3 (P=0.001. Additional improvement in dually infected patients compared to the control group was not statistically significant (P=0.24. In Group 2 (65 patients dually infected subjects count improved from 49 cells/mm3 to 249 cells/mm 3 (P=0.001 where as in control TB uninfected patients improvement was from 50 cells/ mm 3 to 205 cells/mm 3 (P=0.001, there being statistically significant additional improvement in dually infected subjects (P=0.01. Conclusion: Greater increment in CD4 counts with ATT and ART in dually infected patients suggests that TB additionally influences the reduction of CD4 counts in HIV patients.
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The diet of an individual diagnosed with anorexia nervosa
SRBOVÁ, Martina
2015-01-01
The aim of this Bachelor thesis entitled "A diet of individual with a diagnosis of anorexia nervosa" was to monitor the content and quality of the diet of people with a diagnosis of anorexia nervosa. Anorexia nervosa is a very serious disease belonging to the group of eating disorders. The prevalence of this disease increases, to which primarily affect media and requirements of today's society excessively slender figure, other factors that influence the formation of anorexia nervosa include b...
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Griffin, Simon J; Simmons, Rebecca K; Williams, Kate M; Prevost, A Toby; Hardeman, Wendy; Grant, Julie; Whittle, Fiona; Boase, Sue; Hobbis, Imogen; Brage, Soren; Westgate, Kate; Fanshawe, Tom; Sutton, Stephen; Wareham, Nicholas J; Kinmonth, Ann Louise
2011-04-04
The increasing prevalence of type 2 diabetes poses both clinical and public health challenges. Cost-effective approaches to prevent progression of the disease in primary care are needed. Evidence suggests that intensive multifactorial interventions including medication and behaviour change can significantly reduce cardiovascular morbidity and mortality among patients with established type 2 diabetes, and that patient education in self-management can improve short-term outcomes. However, existing studies cannot isolate the effects of behavioural interventions promoting self-care from other aspects of intensive primary care management. The ADDITION-Plus trial was designed to address these issues among recently diagnosed patients in primary care over one year. ADDITION-Plus is an explanatory randomised controlled trial of a facilitator-led, theory-based behaviour change intervention tailored to individuals with recently diagnosed type 2 diabetes. 34 practices in the East Anglia region participated. 478 patients with diabetes were individually randomised to receive (i) intensive treatment alone (n = 239), or (ii) intensive treatment plus the facilitator-led individual behaviour change intervention (n = 239). Facilitators taught patients key skills to facilitate change and maintenance of key behaviours (physical activity, dietary change, medication adherence and smoking), including goal setting, action planning, self-monitoring and building habits. The intervention was delivered over one year at the participant's surgery and included a one-hour introductory meeting followed by six 30-minute meetings and four brief telephone calls. Primary endpoints are physical activity energy expenditure (assessed by individually calibrated heart rate monitoring and movement sensing), change in objectively measured dietary intake (plasma vitamin C), medication adherence (plasma drug levels), and smoking status (plasma cotinine levels) at one year. We will undertake an intention
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Ben-Porath, Denise D.
2004-01-01
Therapists often struggle with managing intersession contact with clients diagnosed with borderline personality disorder, particularly when dangerous and life-threatening symptoms are communicated (Gunderson, 1996). Difficulties have arisen, in part, because previous phone contacts with this population have failed to recognize the importance of…
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Toriumi, Haruki; Tatarishvili, Jemal; Tomita, Minoru; Tomita, Yutaka; Unekawa, Miyuki; Suzuki, Norihiro
2009-10-01
The functional role of arteriolo-arteriolar anastomosis (AAA) between the middle cerebral artery (MCA) and anterior cerebral artery in local hemodynamics is unknown, and was investigated here. Blood flow in AAAs was examined using fluorescein isothiocyanate-labeled red blood cells (RBCs) as a flow indicator in 16 anesthetized C57BL/6J mice before and after MCA occlusion up to 7 experimental days. We observed paradoxical flow in AAAs; labeled RBCs entered from both the MCA and anterior cerebral artery sides and the opposing flows met at a branching T-junction, where the flows combined and passed into a penetrating arteriole. The dually fed T-junction was not fixed in position, but functionally jumped to adjacent T-junctions in response to changing hemodynamic conditions. On MCA occlusion, RBC flow from the MCA side immediately stopped. After a period of "hesitation," blood started to move retrogradely in one of the MCA branches toward the MCA stem. The retrograde blood flow was statistically significantly (P<0.05), serving to feed blood to other MCA branches after a lag period. In capillaries, MCA occlusion induced immediate RBC disappearance in the ischemic core and to a lesser extent in the marginal zone near AAAs. At day 3 after ischemia, we recognized the beginning of remodeling with angiogenesis centering on AAAs. AAAs appear to play a key role in local hemodynamic homeostasis, both in the normal state and in the development of collateral channels and revascularization during ischemia.
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Diagnosed but Not Undiagnosed Diabetes Is Associated with Depression in Rural Areas
Directory of Open Access Journals (Sweden)
Zhao Li
2016-11-01
Full Text Available Background: There is a lack of study on the relation between undiagnosed diabetes and depression in the general population. Methods: A total of 11,531 adults were examined using a multistage cluster sampling method to select a representative sample of individuals who were at least 35 years old. Subjects were classified into three groups: no diabetes (ND, diagnosed diabetes (DD, and undiagnosed diabetes (UD. The participants were surveyed with the Patient Health Questionnaire-9 (PHQ-9. Results: Of all the 11,531 participants, the prevalence of depression was higher in the DD group than in the other two groups. Multi variable logistic regression analyses show that the DD group had significantly higher odds for depression compared with the ND group (p < 0.01, while the UD group showed no significant differences compared to the ND group. Subgroup analyses show that diagnosed diabetes in subjects with a lower educational level, compared with subjects with an educational level of high school or above, had higher odds for a PHQ-9 score ≥5 (p < 0.01. Conclusion: In this general population, diagnosed but not undiagnosed diabetes was significantly associated with depression. Much higher odds for depression were found among diagnosed diabetic individuals with a lower level of education.
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Axis I psychiatric diagnoses in adolescents and young adults with 22q11 deletion syndrome
Ousley, O.Y.; Smearman, E.; Fernandez-Carriba, S.; Rockers, K.A.; Coleman, K.; Walker, E.F.; Cubells, J.F.
2017-01-01
Background 22q11.2 deletion syndrome (22q11DS) associates with schizophrenia spectrum disorders (SSDs), autism spectrum disorders (ASDs), and other psychiatric disorders, but co-occurrence of diagnoses are not well described. Methods We evaluated the co-occurrence of SSDs, ASDs and other axis I psychiatric diagnoses in 31 adolescents and adults with 22q11DS, assessing ASDs using either stringent Collaborative Program for Excellence in Autism (ASD-CPEA) criteria, or less stringent DSM-IV criteria alone (ASD-DSM-IV). Results Ten (32%) individuals met criteria for an SSD, five (16%) for ASD-CPEA, and five others (16%) for ASD-DSM-IV. Of those with ASD-CPEA, one (20%) met SSD criteria. Of those with ASD-DSM-IV, four (80%) met SSD criteria. Depressive disorders (8 individuals; 26%) and anxiety disorders (7; 23%) sometimes co-occurred with SSDs and ASDs. SSDs, ASDs, and anxiety occurred predominantly among males and depression predominantly among females. Conclusions Individuals with 22q11DS can manifest SSDs in the presence or absence of ASDs and other axis I diagnoses. The results suggest that standard clinical care should include childhood screening for ASDs, and later periodic screening for all axis I diagnoses. PMID:23916466
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A Narrative Approach to Supporting Students Diagnosed with Learning Disabilities
Lambie, Glenn W.; Milsom, Amy
2010-01-01
Students diagnosed with learning disabilities experience many challenges that school counselors may address through narrative therapy. Narrative therapy is a postmodern, social constructionist approach based on the theoretical construct that individuals create their notions of truth and meaning of life through interpretive stories. This article…
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Ropponen, Annina; Korhonen, Tellervo; Svedberg, Pia; Koskenvuo, Markku; Silventoinen, Karri; Kaprio, Jaakko
2013-12-01
To investigate whether stability or changes in smoking predict disability pension (DP) due to low back diagnoses (LBD) and musculoskeletal diagnoses (MSD) after taking familial confounding into account using a co-twin design. Longitudinal smoking patterns and multiple covariates in a population-based cohort of 17,451 Finnish twins (6959 complete pairs) born before 1958 were surveyed through questionnaires in 1975 and 1981. The outcome data were collected from the national pension registers until the end of 2004. Cox proportional hazards regression models were used for statistical analyses. Disability pension due to low back diagnoses was granted to 408 individuals and disability pension due to musculoskeletal diagnoses to 1177 individuals during the follow-up of 23 years. Being a persistent smoker (current smoker both 1975 and 1981) predicted a significantly increased risk for disability pension (hazard ratio 1.69, 95% confidence interval 1.46, 1.97) compared to those individuals who had never smoked. The association remained when several confounding factors, including familial factors, were taken into account. Persistent smoking predicts early disability pension due to musculoskeletal diagnoses and low back diagnoses independently from numerous confounding factors, including familial effects shared by the co-twins. © 2013.
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Directory of Open Access Journals (Sweden)
Fanshawe Tom
2011-04-01
Full Text Available Abstract Background The increasing prevalence of type 2 diabetes poses both clinical and public health challenges. Cost-effective approaches to prevent progression of the disease in primary care are needed. Evidence suggests that intensive multifactorial interventions including medication and behaviour change can significantly reduce cardiovascular morbidity and mortality among patients with established type 2 diabetes, and that patient education in self-management can improve short-term outcomes. However, existing studies cannot isolate the effects of behavioural interventions promoting self-care from other aspects of intensive primary care management. The ADDITION-Plus trial was designed to address these issues among recently diagnosed patients in primary care over one year. Methods/Design ADDITION-Plus is an explanatory randomised controlled trial of a facilitator-led, theory-based behaviour change intervention tailored to individuals with recently diagnosed type 2 diabetes. 34 practices in the East Anglia region participated. 478 patients with diabetes were individually randomised to receive (i intensive treatment alone (n = 239, or (ii intensive treatment plus the facilitator-led individual behaviour change intervention (n = 239. Facilitators taught patients key skills to facilitate change and maintenance of key behaviours (physical activity, dietary change, medication adherence and smoking, including goal setting, action planning, self-monitoring and building habits. The intervention was delivered over one year at the participant's surgery and included a one-hour introductory meeting followed by six 30-minute meetings and four brief telephone calls. Primary endpoints are physical activity energy expenditure (assessed by individually calibrated heart rate monitoring and movement sensing, change in objectively measured dietary intake (plasma vitamin C, medication adherence (plasma drug levels, and smoking status (plasma cotinine levels at
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Winkley, Kirsty; Stahl, Daniel; Chamley, Mark; Stopford, Rosanna; Boughdady, Monica; Thomas, Stephen; Amiel, Stephanie A; Forbes, Angus; Ismail, Khalida
2016-01-01
The aims were to determine the association between individual and neighbourhood factors and attendance at structured education amongst people with newly diagnosed type 2 diabetes (T2DM). Multi-level analysis of questionnaire data from a prospective cohort of adults newly diagnosed T2DM. Setting was primary care, London, UK. Main outcome was attendance at structured education within 2 years. Of 1790 people recruited, attendance data were available for 1626 (91%). Only 22.4% (n=365/1626) attended education. Attendance was independently associated with female gender (OR 1.28, 95% CI 1.05-1.46), lower HbA1c (OR 0.98 mmol/mol 95% CI 0.97-0.99) and non-smoker status (OR 1.36, 95% CI 1.07-1.55). General practice covariates, achievement of primary care targets for glycaemic control (OR 1.05, 95% C.I. 1.01-1.08) and recording of retinal screening (OR 0.96, 95% C.I. 0.93-0.99) were independently associated with attendance but unexplained general practice clustering accounted for 17% of the variance. Education uptake is low amongst people with new onset T2DM. Attenders are more likely to be female, non-smokers with better HbA1c. General practices achieving glycaemic targets are more likely to have patients who attend education. Strategies are needed to improve attendance at structured diabetes education particularly amongst hard to reach groups. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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Directory of Open Access Journals (Sweden)
Szu Han Lin
2018-04-01
Full Text Available Background Cardiovascular disease is a major cause of mortality and morbidity in people with type 2 diabetes mellitus (T2DM. Studies have consistently identified dyslipidemia as an important risk factor for the development of macrovascular disease. The landmark United Kingdom Prospective Diabetes Study has shown that metformin therapy reduces cardiovascular events in overweight people with T2DM. This study investigates the effect of metformin monotherapy on serum lipid profile in statin-naïve individuals with newly diagnosed T2DM, and whether the effect, if any, is dosage-related. Methods This cohort study enrolled individuals exceeding 20 years of age, with recent onset T2DM, who received at least 12 months of metformin monotherapy and blood tests for serum lipid at 6-month intervals. Exclusion criteria involved people receiving any additional antidiabetic medication or lipid-lowering drug therapy. Lipid-modifying effect of metformin was recorded as levels of serum triglycerides (TG, high density lipoprotein cholesterol (HDL-C, and low density lipoprotein cholesterol (LDL-C measured at six month intervals. Results The study enrolled 155 participants with a mean age of 58.6 years and average glycosylated hemoglobin A1c of 8%. After initiating metformin therapy, LDL-C was significantly reduced from 111 mg/dl to 102 mg/dL at 6 months (P < 0.001, TG was reduced from 132 mg/dl to 122 mg/dL at 12 months (P = 0.046, and HDL-C increased from 45.1 mg/dL to 46.9 mg/dL at 12 months (P = 0.02. However, increasing the dosage of metformin yielded no significant effect on its lipid-lowering efficacy. Discussion Metformin monotherapy appreciably improves dyslipidemia in statin-naive people with T2DM. Its lipid-modifying effect may be attributable to insulin sensitization, reduction of irreversibly glycated LDL-C, and weight loss. In practice, people with dyslipidemia who are ineligible for lipid-lowering agents may benefit from metformin therapy
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Nursing diagnoses in elderly residents of a nursing home: a case in Turkey.
Güler, Elem Kocaçal; Eşer, Ismet; Khorshid, Leyla; Yücel, Sebnem Çinar
2012-01-01
There are limited studies on nursing diagnoses of the elderly living in nursing homes worldwide. This study aimed to define the most frequent nursing diagnoses in the elderly residents of a nursing home elder care and rehabilitation center. Seventy-four elderly individuals were included in the study. Data were collected using the "Elderly Individual's Introduction Form" between April 2007 to August 2007. The content of the form was based on a guide to gerontologic assessment, and Gordon's Functional Health Patterns. The nursing diagnoses (NANDA-I Taxonomy II) were identified by the 2 researchers separately according to the defining characteristics and the risk factors. The consistency between the nursing diagnoses defined by the 2 researchers was evaluated using Cohen's kappa (κ). There was an 84.7% agreement about nursing diagnoses defined by the 2 researchers separately. The weighted kappa consistency analyses showed there was an adequate level of consistency (κ = 0.710), and the findings were significant (p health maintenance (81.2%), risk for falls (77%), and impaired physical mobility (73%). The diagnosis of ineffective role performance was more frequent in patients with dementia (x(2) =10.993, df = 1, p = 0.001). There was a very significant relationship between dementia and the diagnosis of impaired verbal communication (x(2) = 32.718, df = 1, p = 0.0001). The relationship between mobility disorder and self-care deficit was also significant (x(2) = 19.411, df = 1, p = 0.0001). To improve quality in patient care, nurses should use nursing diagnoses with a systematic assessment and should help the elderly in health promotion or use of the maximum current potential. Copyright © 2012 Elsevier Inc. All rights reserved.
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Kadouch, D. J.; van Haersma de With, A.; Elshot, Y. S.; Peppelman, M.; Bekkenk, M. W.; Wolkerstorfer, A.; Eekhout, I.; Prinsen, C. A. C.; de Rie, M. A.
2017-01-01
Reflectance confocal microscopy (RCM) imaging can be used to diagnose and subtype basal cell carcinoma (BCC) but relies on individual morphologic pattern recognition that might vary among users. We assessed the inter-rater and intra-rater agreement of RCM in correctly diagnosing and subtyping BCC.
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Stroke mimic diagnoses presenting to a hyperacute stroke unit.
Dawson, Ang; Cloud, Geoffrey C; Pereira, Anthony C; Moynihan, Barry J
2016-10-01
Stroke services have been centralised in several countries in recent years. Diagnosing acute stroke is challenging and a high proportion of patients admitted to stroke units are diagnosed as a non-stroke condition (stroke mimics). This study aims to describe the stroke mimic patient group, including their impact on stroke services. We analysed routine clinical data from 2,305 consecutive admissions to a stroke unit at St George's Hospital, London. Mimic groupings were derived from 335 individual codes into 17 groupings. From 2,305 admissions, 555 stroke mimic diagnoses were identified (24.2%) and 72% of stroke mimics had at least one stroke risk factor. Common mimic diagnoses were headache, seizure and syncope. Medically unexplained symptoms and decompensation of underlying conditions were also common. Median length of stay was 1 day; a diagnosis of dementia (p=0.028) or needing MRI (p=0.006) was associated with a longer stay. Despite emergency department assessment by specialist clinicians and computed tomography brain, one in four suspected stroke patients admitted to hospital had a non-stroke diagnosis. Stroke mimics represent a heterogeneous patient group with significant impacts on stroke services. Co-location of stroke and acute neurology services may offer advantages where service reorganisation is being considered. © Royal College of Physicians 2016. All rights reserved.
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Joynt Maddox, Karen E; Chen, Lena M; Zuckerman, Rachael; Epstein, Arnold M
2018-02-01
More than 3 million Medicare beneficiaries use home health care annually, yet little is known about how vulnerable beneficiaries fare in the home health setting. This is particularly important given the recent launch of Medicare's Home Health Value-Based Purchasing model. The objective of this study was to determine odds of adverse clinical outcomes associated with dual enrollment in Medicaid and Medicare as a marker of individual poverty, residence in a low-income ZIP code tabulation area (ZCTA), and black race. Retrospective observational study using individuals-level logistic regression. Home health care. Fee-for-service Medicare beneficiaries from 2012 to 2014. Thirty- and 60-day clinical outcomes, including readmissions, admissions, and emergency department (ED) use. Home health agencies serving a high proportion of dually enrolled, low-income ZCTA, or black beneficiaries were less often high-quality. Dually-enrolled, low-income ZCTA, and Black beneficiaries receiving home health care after hospitalization had higher risk-adjusted odds of 30-day readmission (odds ratio [OR] = 1.08, P home health care without preceding hospitalization had higher 60-day admission (OR = 1.06, P home health services who are dually enrolled, live in a low-income neighborhood, or are black have higher rates of adverse clinical outcomes. These populations may be an important target for quality improvement under Home Health Value-Based Purchasing. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
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Palermo, M.T.; Bogaerts, S.
2015-01-01
Posthumous diagnoses are not uncommonly given to notorious public and historical figures by applying retrospectively, and typically in the absence of the individual being diagnosed, contemporary diagnostic criteria. Although this may be relatively easy and free of consequences when it concerns
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... Submit" /> Information For… Media Policy Makers Diagnosing Tic Disorders Language: English (US) Español (Spanish) Recommend on ... or postviral encephalitis). Persistent (Chronic) Motor or Vocal Tic Disorder To be diagnosed with a persistent tic ...
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Diagnosing ADHD in Danish primary school children
DEFF Research Database (Denmark)
Tegtmejer, Thyge; Hjörne, Eva; Säljö, Roger
2018-01-01
This study of institutional categorization reports an investigation of the practices, procedures and assumptions of psychiatric staff members when diagnosing ADHD. The main data upon which the study is based consist of transcribed audio recordings of meetings in the psychiatric clinic. Here...... children referred from primary schools on the suspicion of ADHD are attended to. The tools and procedures for gathering information are shown to produce decontextualized and individualizing representations of children’s conduct. The evaluation against a number of norms is found to be central. Finally...
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Shin, J; Cho, K H; Choi, Y; Lee, S G; Park, E-C; Jang, S-I
2016-03-01
The study aims to determine whether dyslipidemia patients living in less affluent neighborhood are at a higher risk of mortality compared to those living in more affluent neighborhoods. A population-based cohort study was conducted using a stratified representative sampling from the National Health Insurance claim data from 2002 to 2013. The target subjects comprise patients newly diagnosed with dyslipidemia receiving medication. We performed a survival analysis using the Cox proportional hazard model. Of 11,946 patients with dyslipidemia, 1053 (8.8%) subjects died during the follow-up period. Of the dyslipidemia patients earning a middle-class income, the adjusted HR in less affluent neighborhoods was higher than that in the more affluent neighborhoods compared to the reference category of high individual SES in more affluent neighborhoods (less affluent; hazard ratio (HR) = 1.64, 95% confidence interval (CI): 1.35-1.99 vs. more affluent; HR = 1.48, 95% CI: 1.20-1.81, respectively). We obtained consistent results in patients with lower income, wherein the adjusted HR in less affluent neighborhoods was higher than that in more affluent neighborhoods (less affluent; HR = 1.52, 95% CI: 1.16-1.97 vs. more affluent; HR = 1.41, 95% CI: 1.04-1.92, respectively). Living in a less affluent neighborhood contributes to higher mortality among dyslipidemia patients. The individual- and neighborhood-level variables cumulatively affect individuals such that the most at-risk individuals include those having both individual- and neighborhood-level risk factors. These findings raise important clinical and public health concerns and indicate that neighborhood SES approaches should be essentially considered in health-care policies similar to individual SES. Copyright © 2015 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University
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The Use of Narrative Therapy with Clients Diagnosed with Bipolar Disorder
Ngazimbi, Evadne E.; Lambie, Glenn W.; Shillingford, M. Ann
2008-01-01
Clients diagnosed with bipolar disorder often suffer from mood instability, and research suggests that these clients need both counseling services and pharmacotherapy. Narrative therapy is a social constructionist approach grounded on the premise that there is no single "truth"; individuals may create new meanings and retell their stories to…
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On Categorical Diagnoses in "DSM-V": Cutting Dimensions at Useful Points?
Kamphuis, Jan H.; Noordhof, Arjen
2009-01-01
The "Diagnostic and Statistical Manual of Mental Disorders" (5th ed.; "DSM-V") will likely place more emphasis on dimensional representation of mental disorders. However, it is often argued that categorical diagnoses are preferable for professional communication, clinical decision-making, or distinguishing between individuals with and without a…
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A novel approach to modeling and diagnosing the cardiovascular system
Energy Technology Data Exchange (ETDEWEB)
Keller, P.E.; Kangas, L.J.; Hashem, S.; Kouzes, R.T. [Pacific Northwest Lab., Richland, WA (United States); Allen, P.A. [Life Link, Richland, WA (United States)
1995-07-01
A novel approach to modeling and diagnosing the cardiovascular system is introduced. A model exhibits a subset of the dynamics of the cardiovascular behavior of an individual by using a recurrent artificial neural network. Potentially, a model will be incorporated into a cardiovascular diagnostic system. This approach is unique in that each cardiovascular model is developed from physiological measurements of an individual. Any differences between the modeled variables and the variables of an individual at a given time are used for diagnosis. This approach also exploits sensor fusion to optimize the utilization of biomedical sensors. The advantage of sensor fusion has been demonstrated in applications including control and diagnostics of mechanical and chemical processes.
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Best waveform score for diagnosing keratoconus
Directory of Open Access Journals (Sweden)
Allan Luz
2013-12-01
Full Text Available PURPOSE: To test whether corneal hysteresis (CH and corneal resistance factor (CRF can discriminate between keratoconus and normal eyes and to evaluate whether the averages of two consecutive measurements perform differently from the one with the best waveform score (WS for diagnosing keratoconus. METHODS: ORA measurements for one eye per individual were selected randomly from 53 normal patients and from 27 patients with keratoconus. Two groups were considered the average (CH-Avg, CRF-Avg and best waveform score (CH-WS, CRF-WS groups. The Mann-Whitney U-test was used to evaluate whether the variables had similar distributions in the Normal and Keratoconus groups. Receiver operating characteristics (ROC curves were calculated for each parameter to assess the efficacy for diagnosing keratoconus and the same obtained for each variable were compared pairwise using the Hanley-McNeil test. RESULTS: The CH-Avg, CRF-Avg, CH-WS and CRF-WS differed significantly between the normal and keratoconus groups (p<0.001. The areas under the ROC curve (AUROC for CH-Avg, CRF-Avg, CH-WS, and CRF-WS were 0.824, 0.873, 0.891, and 0.931, respectively. CH-WS and CRF-WS had significantly better AUROCs than CH-Avg and CRF-Avg, respectively (p=0.001 and 0.002. CONCLUSION: The analysis of the biomechanical properties of the cornea through the ORA method has proved to be an important aid in the diagnosis of keratoconus, regardless of the method used. The best waveform score (WS measurements were superior to the average of consecutive ORA measurements for diagnosing keratoconus.
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LENUS (Irish Health Repository)
Lyne, John Paul
2011-01-01
A retrospective patient record review was conducted to examine comorbid psychiatric diagnoses, and comorbid substance use, among 465 patients below 45 years of age, presenting to a national alcohol addiction treatment unit in Dublin, between 1995 and 2006. Rates were high for depressive disorder (25.3%) particularly among females (35.4%). Lifetime reported use of substances other than alcohol was 39.2%, and further analysis showed significantly higher rates of deliberate self-harm among this group. Lifetime reported use of ecstasy was also significantly associated with depression in this alcohol-dependent population using logistic regression analysis. Implications and limitations of the findings are discussed.
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Online Narratives by Adults with ADHD Who Were Diagnosed in Adulthood
Fleischmann, Amos; Miller, Erez C.
2013-01-01
This study systematically analyzed life stories of adults with attention-deficit hyperactivity disorder (ADHD) who were diagnosed in adulthood, using an adapted version of Labov's textual-analysis method. These life stories provided an opportunity to examine the processes experienced by these individuals before and after the diagnosis of ADHD,…
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Slatore, Christopher G; Falvo, Michael J; Nugent, Shannon; Carlson, Kathleen
2018-05-01
Many veterans of the wars in Afghanistan and Iraq have concomitant respiratory conditions and mental health conditions. We wanted to evaluate the association of mental health diagnoses with respiratory disease diagnoses among post-deployment veterans. We conducted a retrospective cohort study of all Afghanistan and Iraq War veterans who were discharged from the military or otherwise became eligible to receive Veterans Health Administration services. The primary exposure was receipt of a mental health diagnosis and the primary outcome was receipt of a respiratory diagnosis as recorded in the electronic health record. We used multivariable adjusted logistic regression to measure the associations of mental health diagnoses with respiratory diagnoses and conducted several analyses exploring the timing of the diagnoses. Among 182,338 post-deployment veterans, 14% were diagnosed with a respiratory condition, 77% of whom had a concomitant mental health diagnosis. The incidence rates were 5,363/100,000 person-years (p-y), 587/100,000 p-y, 1,450/100,000 p-y, and 233/100,000 p-y for any respiratory disease diagnosis, bronchitis, asthma, and chronic obstructive lung disease diagnoses, respectively, after the date of first Veterans Health Administration utilization. Any mental health diagnosis was associated with increased odds for any respiratory diagnosis (adjusted odds ratio 1.41, 95% confidence interval 1.37-1.46). The association of mental health diagnoses and subsequent respiratory disease diagnoses was stronger and more consistent than the converse. Many Afghanistan and Iraq War veterans are diagnosed with both respiratory and mental illnesses. Comprehensive plans that include care coordination with mental health professionals and treatments for mental illnesses may be important for many veterans with respiratory diseases.
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Schmand, B.; Eikelenboom, P.; van Gool, W.A.
2011-01-01
OBJECTIVES: To examine the influence of age on the value of four techniques for diagnosing Alzheimer's disease (AD). DESIGN: Observational cohort study. SETTING: Alzheimer's Disease Neuroimaging Initiative. PARTICIPANTS: Individuals with mild cognitive impairment (MCI; n=179), individuals with AD
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Indian Academy of Sciences (India)
tribpo
Early DDO photographic observations, published indivi- dually here for the first time, fit the orbit well. Key words:radial velocities—spectroscopic binaries—stars, individual. HD 120803 is a late-type giant star, about 7° north-preceding Arcturus in the sky. Photometry by Häggkvist and Oja (1973) shows its magnitude and ...
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Musliner, K L; Trabjerg, B B; Waltoft, B L; Laursen, T M; Mortensen, P B; Zandi, P P; Munk-Olsen, T
2015-10-01
Depression is known to run in families, but the effects of parental history of other psychiatric diagnoses on depression rates are less well studied. Few studies have examined the impact of parental psychopathology on depression rates in older age groups. We established a population-based cohort including all individuals born in Denmark after 1954 and alive on their 10th birthday (N = 29 76 264). Exposure variables were maternal and paternal history of schizophrenia, bipolar disorder, depression, anxiety or 'other' psychiatric diagnoses. Incidence rate ratios (IRRs) were estimated using Poisson regressions. Parental history of any psychiatric diagnosis increased incidence rates of outpatient (maternal: IRR 1.88, p history. IRRs for parental history of non-affective disorders remained relatively stable across age groups, while IRRs for parental affective disorders (unipolar or bipolar) decreased with age from 2.29-3.96 in the youngest age group to 1.53-1.90 in the oldest group. IRR estimates for all parental diagnoses were similar among individuals aged ⩾41 years (IRR range 1.51-1.90). Parental history of any psychiatric diagnosis is associated with increased incidence rates of unipolar depression. In younger age groups, parental history of affective diagnoses is more strongly associated with rates of unipolar depression than non-affective diagnoses; however, this distinction disappears after age 40, suggesting that parental psychopathology in general, rather than any one disorder, confers risk for depression in middle life.
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DEFF Research Database (Denmark)
Simonsen, Rikke Kildevæld; Giraldi, Annamaria; Kristensen, Ellids
2016-01-01
the period of 1978–2010. Method: Psychiatric morbidity and mortality were identified by data from the Danish Psychiatric Central Research Register and the Cause of Death Register through a retrospective register study of 104 sex-reassigned individuals. Results: Overall, 27.9% of the sample were registered...... as deceased post-SRS with an average age of death of 53.5 years. Conclusions: No significant difference in psychiatric morbidity or mortality was found between male to female and female to male (FtM) save for the total number of psychiatric diagnoses where FtM held a significantly higher number of psychiatric...... diagnoses overall. Despite the over-representation of psychiatric diagnoses both pre- and post-SRS the study found that only a relatively limited number of individuals had received diagnoses both prior to and after SRS. This suggests that generally SRS may reduce psychological morbidity for some individuals...
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Schmand, Ben; Eikelenboom, Piet; van Gool, Willem A.
2011-01-01
To examine the influence of age on the value of four techniques for diagnosing Alzheimer's disease (AD). Observational cohort study. Alzheimer's Disease Neuroimaging Initiative. Individuals with mild cognitive impairment (MCI; n = 179), individuals with AD (n = 91), and normal controls (n = 105).
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Neuroblastoma in Children: Just Diagnosed Information
... Financial Reports Watchdog Ratings Feedback Contact Select Page Neuroblastoma in Children – Just Diagnosed Home > Cancer Resources > Types ... Diagnosed Just Diagnosed In Treatment After Treatment Diagnosing Neuroblastoma Depending on the location of the tumor and ...
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Pulmonary symptoms and diagnoses are associated with HIV in the MACS and WIHS cohorts.
Gingo, Matthew R; Balasubramani, Goundappa K; Rice, Thomas B; Kingsley, Lawrence; Kleerup, Eric C; Detels, Roger; Seaberg, Eric C; Greenblatt, Ruth M; Holman, Susan; Huang, Laurence; Sutton, Sarah H; Bertolet, Marnie; Morris, Alison
2014-04-30
Several lung diseases are increasingly recognized as comorbidities with HIV; however, few data exist related to the spectrum of respiratory symptoms, diagnostic testing, and diagnoses in the current HIV era. The objective of the study is to determine the impact of HIV on prevalence and incidence of respiratory disease in the current era of effective antiretroviral treatment. A pulmonary-specific questionnaire was administered yearly for three years to participants in the Multicenter AIDS Cohort Study (MACS) and Women's Interagency HIV Study (WIHS). Adjusted prevalence ratios for respiratory symptoms, testing, or diagnoses and adjusted incidence rate ratios for diagnoses in HIV-infected compared to HIV-uninfected participants were determined. Risk factors for outcomes in HIV-infected individuals were modeled. Baseline pulmonary questionnaires were completed by 907 HIV-infected and 989 HIV-uninfected participants in the MACS cohort and by 1405 HIV-infected and 571 HIV-uninfected participants in the WIHS cohort. In MACS, dyspnea, cough, wheezing, sleep apnea, and incident chronic obstructive pulmonary disease (COPD) were more common in HIV-infected participants. In WIHS, wheezing and sleep apnea were more common in HIV-infected participants. Smoking (MACS and WIHS) and greater body mass index (WIHS) were associated with more respiratory symptoms and diagnoses. While sputum studies, bronchoscopies, and chest computed tomography scans were more likely to be performed in HIV-infected participants, pulmonary function tests were no more common in HIV-infected individuals. Respiratory symptoms in HIV-infected individuals were associated with history of pneumonia, cardiovascular disease, or use of HAART. A diagnosis of asthma or COPD was associated with previous pneumonia. In these two cohorts, HIV is an independent risk factor for several respiratory symptoms and pulmonary diseases including COPD and sleep apnea. Despite a higher prevalence of chronic respiratory symptoms
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available ... for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed with Cancer Fertility Preservation for Children Diagnosed ... for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed with Cancer Fertility Preservation for Children Diagnosed ...
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Understanding the working alliance with clients diagnosed with anorexia nervosa.
Oyer, Laura; O'Halloran, Mary Sean; Christoe-Frazier, Liesel
2016-01-01
The therapeutic working alliance is a vital ingredient of psychotherapy, specifically for clients diagnosed with anorexia nervosa, as progress is often slow and treatment difficult. This qualitative phenomenological study investigated the experiences of eight clients with anorexia nervosa and seven therapists who work with this population, regarding which therapist factors aided in and challenged the working alliance formation in individual psychotherapy. Data was gathered through semi-structured interviews. Some helpful therapist factors included collaboration, appropriate self-disclosure, providing a warm and safe environment, and willingness to be contacted outside of a session. Unhelpful factors included lack of attunement and objectivity and failure to individualize treatment.
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Diagnosing Dementia—Positive Signs
... Navigation Bar Home Current Issue Past Issues Diagnosing Dementia—Positive Signs Past Issues / Fall 2007 Table of ... easy, affordable blood test that could accurately diagnose Alzheimer's disease (AD)—even before symptoms began to show? Researchers ...
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DEFF Research Database (Denmark)
Konradsen, Hanne; Lillebaek, Troels; Wilcke, Torgny
2014-01-01
a patient with TB, and finally being in medical treatment. Before being diagnosed with TB, patients were weighing between biding their time and deciding to undergo an examination. Social pressure and feelings of social responsibility tended to affect the decision. Having undergone the examination......INTRODUCTION: Tuberculosis (TB) is a disease which affects people worldwide, but there is knowledge lacking about patients' experiences in low-prevalence and high-income countries. AIM: To provide a theoretical framework for the process of being diagnosed with tuberculosis in a Danish setting....... METHOD: A grounded theory design with field studies and qualitative interviews, following the recommendations from Glaser and Strauss. RESULT: A process of being publicly diagnosed was identified, which developed during the patient's trajectory from being on the way to becoming a patient, becoming...
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Web-based phenotyping for Tourette Syndrome: Reliability of common co-morbid diagnoses.
Darrow, Sabrina M; Illmann, Cornelia; Gauvin, Caitlin; Osiecki, Lisa; Egan, Crystelle A; Greenberg, Erica; Eckfield, Monika; Hirschtritt, Matthew E; Pauls, David L; Batterson, James R; Berlin, Cheston M; Malaty, Irene A; Woods, Douglas W; Scharf, Jeremiah M; Mathews, Carol A
2015-08-30
Collecting phenotypic data necessary for genetic analyses of neuropsychiatric disorders is time consuming and costly. Development of web-based phenotype assessments would greatly improve the efficiency and cost-effectiveness of genetic research. However, evaluating the reliability of this approach compared to standard, in-depth clinical interviews is essential. The current study replicates and extends a preliminary report on the utility of a web-based screen for Tourette Syndrome (TS) and common comorbid diagnoses (obsessive compulsive disorder (OCD) and attention deficit/hyperactivity disorder (ADHD)). A subset of individuals who completed a web-based phenotyping assessment for a TS genetic study was invited to participate in semi-structured diagnostic clinical interviews. The data from these interviews were used to determine participants' diagnostic status for TS, OCD, and ADHD using best estimate procedures, which then served as the gold standard to compare diagnoses assigned using web-based screen data. The results show high rates of agreement for TS. Kappas for OCD and ADHD diagnoses were also high and together demonstrate the utility of this self-report data in comparison previous diagnoses from clinicians and dimensional assessment methods. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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Identification of nursing management diagnoses.
Morrison, R S
1997-02-01
Theories from nursing and management provide frameworks for enhancing effectiveness of nursing management practice. The concept nursing management diagnosis has been developed by integrating nursing diagnosis and organizational diagnosis as a basis for nurse manager decision-making. Method triangulation was used to identify problems of managing nursing units, to validate those problems for relevancy to practice, to generate nursing management diagnoses, and to validate the diagnoses. Diagnoses were validated according to a definition of nursing management diagnosis provided. Of the 72 nursing management diagnoses identified, 66 were validated at a 70% level of agreement by nurse managers participating in the study.
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Hospital-diagnosed dementia and suicide
DEFF Research Database (Denmark)
Erlangsen, Annette; Zarit, Steven H; Conwell, Yeates
2008-01-01
OBJECTIVE: The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders. DESIGN: Event-history analysis using time-varying covariates. SETTING: Population-based record linkage. PARTICIPANTS: All individuals...... who are aged 70 or older with dementia have a threefold higher risk than persons with no dementia. The time shortly after diagnosis is associated with an elevated suicide risk. The risk among persons with dementia remains significant when controlling for mood disorders. As many as 26% of the men...... aged 50+ living in Denmark (N=2,474,767) during January 1, 1990 through December 31, 2000. MEASUREMENTS: Outcome of interest is suicide. Relative risks are calculated based on person-days spent in each stratum. RESULTS: A total of 18,648,875 person-years were observed during the 11-year study period...
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Mental Health Nursing in Greece: Nursing Diagnoses and Interventions in Major Depression.
Prokofieva, Margarita; Koukia, Evmorfia; Dikeos, Dimitris
2016-08-01
The aim of the study was to assess nursing diagnoses and nursing interventions that were accordingly implemented during the care of inpatients with major depression in Greece. Twelve nurses working in three major psychiatric hospitals were recruited. Semi-structured interviews were used and audio-recorded data indicated that risk for suicide, social isolation, low self-esteem, sleep problems, and imbalanced nutrition are the nursing diagnoses most commonly reported. Establishing trust and rapport is the primary intervention, followed by specific interventions according to each diagnosis and the individualized care plan. The findings of the study also highlight the need for nursing training in order to teach nurses initial assessment procedures and appropriate evidence-based intervention techniques.
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Validation of nursing management diagnoses.
Morrison, R S
1995-01-01
Nursing management diagnosis based on nursing and management science, merges "nursing diagnosis" and "organizational diagnosis". Nursing management diagnosis is a judgment about nursing organizational problems. The diagnoses provide a basis for nurse manager interventions to achieve outcomes for which a nurse manager is accountable. A nursing organizational problem is a discrepancy between what should be happening and what is actually happening that prevents the goals of nursing from being accomplished. The purpose of this study was to validate 73 nursing management diagnoses identified previously in 1992: 71 of the 72 diagnoses were considered valid by at least 70% of 136 participants. Diagnoses considered to have high priority for future research and development were identified by summing the mean scores for perceived frequency of occurrence and level of disruption. Further development of nursing management diagnoses and testing of their effectiveness in enhancing decision making is recommended.
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Experiencing Community: Perspectives of Individuals Diagnosed as Having Serious Mental Illness
Bromley, Elizabeth; Gabrielian, Sonya; Brekke, Benjamin; Pahwa, Rohini; Daly, Kathleen A.; Brekke, John S.; Braslow, Joel T.
2013-01-01
Objective Community integration is recognized as a crucial component of recovery from serious mental illness. Although the construct of community integration can be measured with structured instruments, little is known about the subjective and experiential meaning of community and community involvement for persons with serious mental illness. Methods In 2010, 30 individuals with serious mental illness treated in two public mental health clinics completed semistructured interviews that elicited the places and people that they associate with the experience of community and the larger meaning of community in their lives. Results Participants described four experiences as integral to their concepts of community: receiving help, minimizing risk, avoiding stigma, and giving back. Participants looked for communities that provide reliable support, and they described the need to manage community contact in order to protect themselves and others from their symptoms and from discrimination. Most participants experienced communities centered on mental health treatment or mentally ill peers as providing opportunities for positive engagement. Conclusions The experience of having a serious mental illness shapes preferences for and perceptions of community in pervasive ways. Participants describe community involvement not as a means to move away from illness experiences and identities but as a process that is substantially influenced by them. Mental health communities may help individuals with serious mental illness to both manage their illness and recognize and enjoy a sense of community. The findings indicate the need for further research on the relationship between community integration and outcome in serious mental illness. PMID:23545784
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Rosenheck, Robert A; Resnick, Sandra G; Morrissey, Joseph P
2003-06-01
There is great concern about fragmentation of mental health service delivery, especially for dually diagnosed homeless people, and apprehension that such fragmentation adversely affects service access and outcomes. This study first seeks to articulate two alternative approaches to the integration of psychiatric and substance abuse services, one involving an integrated team model and the other a collaborative relationship between agencies. It then applies this conceptualization to a sample of dually diagnosed homeless people who participated in the ACCESS demonstration. Longitudinal outcome data were obtained through interviews at baseline, 3 months, and 12 months with homeless clients with a dual diagnosis (N = 1074) who received ACT-like case management services through the ACCESS demonstration. A survey of ACCESS case managers was conducted to obtain information on: (i) the proportion of clients who received substance abuse services directly from ACCESS case management teams, and the proportion who received services from other agencies; and (ii) the perceived quality of the relationship (i.e. communication, cooperation and trust) between providers--both within the same teams and between agencies. Hierarchical linear modeling was then used to examine the relationship of these two factors to service use and outcome with mixed-model regression analysis. Significant (pintegrated team care is more effective than interagency collaborations. This study broadens the conceptual framework for addressing service system fragmentation by considering both single team integration and interagency coordination, and by considering both program structure and the quality of relationships between providers. Data from a multi-site outcome study demonstrated suggestive associations between perceptions of communication, cooperation and measures of clinical service use. However, the proportion of clients treated entirely within a single team was associated with poorer housing and
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Barroso, Eva; Benito-Sanz, Sara; Belinchón, Alberta; Yuste-Checa, Patricia; Gracia, Ricardo; Aragones, Angel; Campos-Barros, Angel; Heath, Karen E
2010-01-01
Léri-Weill dyschondrosteosis (LWD, MIM 127300), is a dominantly inherited skeletal dysplasia with disproportionate short stature, mesomelic limb shortening, and the characteristic Madelung deformity. Two regions of the pseudoautosomal region 1 (PAR1) have been shown to be involved in LWD, SHOX (short-stature homeobox-containing gene) and the downstream enhancer region. We report our genetic findings of a young girl clinically diagnosed with LWD. We analyzed the proband and her family using MLPA and microsatellite analysis. We identified a deletion, 726-866 kb in size, of the downstream SHOX enhancer region in the proband. Neither parent carried the deletion. Microsatellite analysis showed that the deleted allele was of paternal origin. The mutation is more likely to have arisen from a de novo event but paternal gonadal mosaicism cannot be excluded. In conclusion, we report the clinical and molecular details of the first case of a de novo deletion of the downstream PAR1 region in an LWD individual. De novo deletions of SHOX and the downstream enhancer region must be therefore considered in cases of isolated LWD. Copyright 2010 Elsevier Masson SAS. All rights reserved.
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When Diagnosing ADHD in Young Adults Emphasize Informant Reports, "DSM" Items, and Impairment
Sibley, Margaret H.; Pelham, William E., Jr.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Waxmonsky, James G.; Waschbusch, Daniel A.; Derefinko, Karen J.; Wymbs, Brian T.; Garefino, Allison C.; Babinski, Dara E.; Kuriyan, Aparajita B.
2012-01-01
Objective: This study examined several questions about the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in young adults using data from a childhood-diagnosed sample of 200 individuals with ADHD (age M = 20.20 years) and 121 demographically similar non-ADHD controls (total N = 321). Method: We examined the use of self- versus…
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available ... Provider Pocket Guides Provider Guides Fertility Preservation for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed ... Patient Pocket Guides Patient Guides Fertility Preservation for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed ...
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Munkner, R; Haastrup, S; Jørgensen, T; Andreasen, A H; Kramp, P
2003-02-01
To analyse how committed crimes and substance-related diagnoses are associated with the age on the first contact with the psychiatric hospital system and the age at diagnosing of schizophrenia among schizophrenics. In a register-based study including all Danes diagnosed with schizophrenia born after November 1, 1963, data on criminality, substance-related diagnoses and contacts with the psychiatric hospital system were analysed. Compared with the non-convicted schizophrenics the convicted were older on first contact with the psychiatric hospital system and older when the diagnosis of schizophrenia was first given. In contrast, having a substance-related diagnosis was associated with a younger age on first contact but did not influence the age at which the diagnosis of schizophrenia was given. It is important that both psychiatrists and the judicial system are aware of possible psychotic symptoms in criminal and abusing individuals to enable earlier detection and treatment.
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Archer, Trevor; Kostrzewa, Richard M; Beninger, Richard J; Palomo, Tomas
2008-10-01
Cognitive symptoms, considered in conjunction both with their regional brain and biomarkers as well as affective, attributional and neurodevelopmental components, demonstrate ever-increasing complexity to facilitate conceptualization yet, unavoidably, bedevil diagnosis in neuropsychiatry even before considerations of the enigmatic processes in memory, such as executive function and working memory, are drawn into the myriads of equations that await remedial interpretations. Prefrontal and limbic regions of the brain are involved in a diversity of expressions of cognition, normal or dysfunctional, at synaptic, intracellular and molecular levels that mobilize a concatenation of signaling entities. Serotoninergic neurotransission at prefrontal regions directs cognitive-affective entities that mediate decision-making and goal-directed behaviour. Clinical, non-clinical and basic studies challenge attempts to consolidate the multitude of evidence in order to obtain therapeutic notions to alleviate the disordered status of the diagnosed and yet-to-be diagnosed individuals. Locus of control, a concept of some utility in health-seeking procedures, is examined in three self-report studies from the perspective of a cognitive-emotional situation through observations of ordinary, 'healthy' young and middle-aged individuals, to assess the predictors of internal and external locus of control. A notion based on high level executive functioning in the dorsolateral prefrontal cortex (DLPFC) in individuals characterised by internal locus of control is contrasted with a hypofunctional executive DLPFC, characterising individuals that express an external locus of control, is discussed.
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DEFF Research Database (Denmark)
Eldrup, Nikolaj; Sillesen, Henrik; Prescott, Eva
2006-01-01
We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease.......We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease....
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Carbonell, Claudia L.
This literature review of attention deficit hyperactivity disorder (ADHD) reviews the diagnosis and treatment options for children diagnosed with ADHD. It describes the complexity of ADHD, its symptoms, treatments, and implications on a child's social and academic development as well as strategies for assisting such children. Individual sections…
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... Types Seasonal Avian Swine Variant Pandemic Other Diagnosing Flu Questions & Answers Language: English (US) Español Recommend on ... How do I know if I have the flu? Your respiratory illness might be the flu if ...
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Diagnosing binge eating disorder in a primary care setting.
Montano, C Brendan; Rasgon, Natalie L; Herman, Barry K
2016-01-01
Binge eating disorder (BED), now recognized as a distinct eating disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, is the most prevalent eating disorder. Although nearly half of individuals with BED are obese, BED also occurs in nonobese individuals. Despite the relatively high percentage of weight loss treatment-seeking individuals meeting BED criteria, primary care physicians may not be familiar with or have ever diagnosed BED. Many providers may also have difficulty distinguishing BED as a contributory factor in obesity. This review differentiates BED from other causes of obesity by describing how obese individuals with BED differ from obese individuals without BED and from nonobese individuals with BED in areas including psychopathology, behavior, genetics, physiology, quality of life and productivity. The ways in which health-care providers can identify individuals who may have BED are also highlighted so the proper course of treatment is pursued. Overall, obese individuals with BED demonstrate a number of key characteristics that differentiate them from obese individuals without eating disorders, including increased impulsivity in response to food stimuli with loss of control over eating, resulting in the consumption of more calories. They also experience significant guilt and other negative emotions following a meal. In addition, individuals with BED patients have more psychiatric comorbidity, display more psychopathology, exhibit longer binge durations, consume more meals as snacks during the day and have less dietary restraint compared with individuals with BED who are not obese. However, the differences between individuals with BED who are obese versus not obese are not as prominent. Taken together, the evidence appears to support the conclusion that BED is a unique and treatable neurobehavioral disorder associated with distinct behavioral and psychological profiles and distinct medical and functional outcomes, and that
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Dance for Individuals With Dementia.
Lapum, Jennifer L; Bar, Rachel J
2016-03-01
The movement and music associated with dance plays an important role in many individuals' lives and can become imprinted upon the body and mind. Dance is thus closely associated with memory because of these deep connections. Without conscious thought, dance has the potential to be initiated as individuals age. In the current article, the authors share narrative reflections about their experiences with, and the potential of, dance as an intervention for aging populations diagnosed with dementia-related diseases. They draw upon their experiences in working with the aging population and a dance program currently being developed by Canada's National Ballet School and Baycrest Health Sciences for individuals with dementia-related diseases in long-term care. The current article is structured as dialogue between the authors because it mimics dance as a dialogical encounter between movement and music, and/or between individuals. Copyright 2016, SLACK Incorporated.
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White Paper: Movement System Diagnoses in Neurologic Physical Therapy.
Hedman, Lois D; Quinn, Lori; Gill-Body, Kathleen; Brown, David A; Quiben, Myla; Riley, Nora; Scheets, Patricia L
2018-04-01
The APTA recently established a vision for physical therapists to transform society by optimizing movement to promote health and wellness, mitigate impairments, and prevent disability. An important element of this vision entails the integration of the movement system into the profession, and necessitates the development of movement system diagnoses by physical therapists. At this point in time, the profession as a whole has not agreed upon diagnostic classifications or guidelines to assist in developing movement system diagnoses that will consistently capture an individual's movement problems. We propose that, going forward, diagnostic classifications of movement system problems need to be developed, tested, and validated. The Academy of Neurologic Physical Therapy's Movement System Task Force was convened to address these issues with respect to management of movement system problems in patients with neurologic conditions. The purpose of this article is to report on the work and recommendations of the Task Force. The Task Force identified 4 essential elements necessary to develop and implement movement system diagnoses for patients with primarily neurologic involvement from existing movement system classifications. The Task Force considered the potential impact of using movement system diagnoses on clinical practice, education and, research. Recommendations were developed and provided recommendations for potential next steps to broaden this discussion and foster the development of movement system diagnostic classifications. The Task Force proposes that diagnostic classifications of movement system problems need to be developed, tested, and validated with the long-range goal to reach consensus on and adoption of a movement system diagnostic framework for clients with neurologic injury or disease states.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A198).
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Concordance of DSM-IV Axis I and II diagnoses by personal and informant's interview.
Schneider, Barbara; Maurer, Konrad; Sargk, Dieter; Heiskel, Harald; Weber, Bernhard; Frölich, Lutz; Georgi, Klaus; Fritze, Jürgen; Seidler, Andreas
2004-06-30
The validity and reliability of using psychological autopsies to diagnose a psychiatric disorder is a critical issue. Therefore, interrater and test-retest reliability of the Structured Clinical Interview for DSM-IV Axis I and Personality Disorders and the usefulness of these instruments for the psychological autopsy method were investigated. Diagnoses by informant's interview were compared with diagnoses generated by a personal interview of 35 persons. Interrater reliability and test-retest reliability were assessed in 33 and 29 persons, respectively. Chi-square analysis, kappa and intraclass correlation coefficients, and Kendall's tau were used to determine agreement of diagnoses. Kappa coefficients were above 0.84 for substance-related disorders, mood disorders, and anxiety and adjustment disorders, and above 0.65 for Axis II disorders for interrater and test-retest reliability. Agreement by personal and relative's interview generated kappa coefficients above 0.79 for most Axis I and above 0.65 for most personality disorder diagnoses; Kendall's tau for dimensional individual personality disorder scores ranged from 0.22 to 0.72. Despite of a small number of psychiatric disorders in the selected population, the present results provide support for the validity of most diagnoses obtained through the best-estimate method using the Structured Clinical Interview for DSM-IV Axis I and Personality Disorders. This instrument can be recommended as a tool for the psychological autopsy procedure in post-mortem research. Copyright 2004 Elsevier Ireland Ltd.
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Correlation of antemortem diagnoses and postmortem diagnoses in ...
African Journals Online (AJOL)
Background: The postmortem examination is a veritable means of ascertaining the correct diagnoses. Over the years, there has been a severe drop in the number of requests for postmortem examination despite its numerous advantages and benefits. The study is aimed at showing the pivotal role of the autopsy in medical ...
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Hope, emotion regulation, and psychosocial well-being in patients newly diagnosed with cancer.
Peh, Chao Xu; Kua, Ee Heok; Mahendran, Rathi
2016-05-01
Patients newly diagnosed with cancer are often confronted with feelings of uncertainty and life threat. A significant proportion may report impairments in psychosocial well-being. Previous studies examining protective psychological factors such as hope and emotion regulation (ER) have yet to investigate these processes concurrently within a common self-regulation framework and/or focus on newly diagnosed patients. The present study aimed to examine how hope and ER may relate to psychosocial outcomes of patients newly diagnosed with cancer. The present study used a cross-sectional design with self-report questionnaires. Participants were newly diagnosed patients (N = 101) recruited from three cancer therapy clinics in a hospital. Patients completed measures of hope, ER (cognitive reappraisal and expressive suppression), and psychosocial well-being (life satisfaction and negative affectivity). Findings showed that (1) hope and reappraisal, but not suppression, were associated with well-being and (2) the interaction between hope and reappraisal was associated with well-being; reappraisal was not associated with well-being in high hope patients, while high reappraisal was associated with better well-being in low hope patients. Individual differences in hope and reappraisal appeared to be associated with psychosocial outcomes in newly diagnosed cancer patients. Hopeful thinking appeared to benefit patients' psychosocial well-being. In addition, an interaction effect between hope and reappraisal suggested that reappraisal as an ER strategy may be particularly adaptive for patients with low hope.
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Subclassification of newly diagnosed glioblastomas through an immunohistochemical approach.
Directory of Open Access Journals (Sweden)
Siobhan Conroy
Full Text Available Molecular signatures in Glioblastoma (GBM have been described that correlate with clinical outcome and response to therapy. The Proneural (PN and Mesenchymal (MES signatures have been identified most consistently, but others including Classical (CLAS have also been reported. The molecular signatures have been detected by array techniques at RNA and DNA level, but these methods are costly and cannot take into account individual contributions of different cells within a tumor. Therefore, the aim of this study was to investigate whether subclasses of newly diagnosed GBMs could be assessed and assigned by application of standard pathology laboratory procedures. 123 newly diagnosed GBMs were analyzed for the tumor cell expression of 23 pre-identified proteins and EGFR amplification, together allowing for the subclassification of 65% of the tumors. Immunohistochemistry (IHC-based profiling was found to be analogous to transcription-based profiling using a 9-gene transcriptional signature for PN and MES subclasses. Based on these data a novel, minimal IHC-based scheme for subclass assignment for GBMs is proposed. Positive staining for IDH1R132H can be used for PN subclass assignment, high EGFR expression for the CLAS subtype and a combined high expression of PTEN, VIM and/or YKL40 for the MES subclass. The application of the proposed scheme was evaluated in an independent tumor set, which resulted in similar subclass assignment rates as those observed in the training set. The IHC-based subclassification scheme proposed in this study therefore could provide very useful in future studies for stratification of individual patient samples.
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Almqvist, C; Örtqvist, A K; Gong, T; Wallas, A; Ahlén, K M; Ye, W; Lundholm, C
2015-04-01
Exposure to antibiotics in early life may affect future health. Most antibiotics are prescribed in outpatient care, but inpatient exposure is also important. We estimated how specific diagnoses in hospitals corresponded to individual antibiotic exposure. All pregnant women and children from birth to 5 years of age with infectious diseases and common inpatient diagnoses between July 2005 and November 2011 were identified from the Swedish National Patient Register. Random samples of individuals from predefined groups were drawn, and medical records received from the clinics were manually reviewed for antibiotics. Medical records for 4319 hospital visits were requested and 3797 (88%) were received. A quarter (25%) of children diagnosed as premature had received antibiotics, and in children from one to 5 years of age, diagnoses associated with bacterial infections were more commonly treated with antibiotics (62.4-90.6%) than those associated with viruses (6.3-22.2%). Pregnant women who had undergone a Caesarean section were more likely to be treated with antibiotics than those who had had a vaginal delivery (40.1% versus 11.1%). This study defines the proportion of new mothers and young children who received individual antibiotic treatment for specific inpatient diagnoses in Sweden and provides a useful basis for future studies focusing on antibiotic use. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
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Neighborhood Child Opportunity and Individual-Level Pediatric Acute Care Use and Diagnoses.
Kersten, Ellen E; Adler, Nancy E; Gottlieb, Laura; Jutte, Douglas P; Robinson, Sarah; Roundfield, Katrina; LeWinn, Kaja Z
2018-05-01
: media-1vid110.1542/5751513300001PEDS-VA_2017-2309 Video Abstract OBJECTIVES: Although health care providers and systems are increasingly interested in patients' nonmedical needs as a means to improve health, little is known about neighborhood conditions that contribute to child health problems. We sought to determine if a novel, publicly available measure of neighborhood context, the Child Opportunity Index, was associated with pediatric acute care visit frequency and diagnoses. This cross-sectional study included San Francisco residents <18 years of age with an emergency department and/or urgent care visit to any of 3 medical systems ( N = 47 175) between 2007 and 2011. Hot-spot analysis was used to compare the spatial distribution of neighborhood child opportunity and income. Generalized estimating equation logistic regression models were used to examine independent associations between neighborhood child opportunity and frequent acute care use (≥4 visits per year) and diagnosis group after adjusting for neighborhood income and patient age, sex, race and/or ethnicity, payer, and health system. Neighborhood child opportunity and income had distinct spatial distributions, and we identified different clusters of high- and low-risk neighborhoods. Children living in the lowest opportunity neighborhoods had significantly greater odds of ≥4 acute care visits per year (odds ratio 1.33; 95% confidence interval 1.03-1.73) compared with those in the highest opportunity neighborhoods. Neighborhood child opportunity was negatively associated with visits for respiratory conditions, asthma, assault, and ambulatory care-sensitive conditions but positively associated with injury-related visits. The Child Opportunity Index could be an effective tool for identifying neighborhood factors beyond income related to child health. Copyright © 2018 by the American Academy of Pediatrics.
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Peacock, Corey A; Sanders, Gabriel J; Wilson, Kayla A; Fickes-Ryan, Emily J; Corbett, Duane B; von Carlowitz, Kyle-Patrick A; Ridgel, Angela L
2014-08-01
With a substantial increase in diagnosed Parkinson's disease, it is of great importance to examine tolerance and physical measures of evolving exercise interventions. Of particular importance, a multifaceted exercise intervention combining active-assisted cycling and resistance training to older adults diagnosed with Parkinson's disease is being assessed. Fourteen older adults diagnosed with Parkinson's disease and ten healthy older adults (67.5 ± 7.9 years of age) engaged in an 8-week, 24-session, multifaceted exercise protocol. The protocol consisted of both active-assisted cycling and resistance training. Tolerance was measured, as well as multiple indicators of health-related physical fitness. These indicators examined improvements in cardiovascular performance, muscular strength, muscular endurance, and flexibility. Twenty-two older adults and older adults diagnosed with Parkinson's disease tolerated the intervention by completing all 24 sessions. Repeated-measures analysis of variance demonstrated significant (P ≤ 0.003) improvements in cardiovascular performance, muscular strength, muscular endurance, and flexibility for both groups of individuals. The multifaceted intervention is the first to combine both active-assisted cycling and resistance training. The older adult and the older adult diagnosed with Parkinson's disease exhibited both tolerance and health-related improvements in physical fitness following the intervention.
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Poehner, Matthew E.; Zhang, Jie; Lu, Xiaofei
2015-01-01
Dynamic assessment (DA) derives from the sociocultural theory of mind as elaborated by Russian psychologist L. S. Vygotsky. By offering mediation when individuals experience difficulties and carefully tracing their responsiveness, Vygotsky (1998) proposed that diagnoses may uncover abilities that have fully formed as well as those still in the…
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Excess mortality in patients diagnosed with hypothyroidism
DEFF Research Database (Denmark)
Thvilum, Marianne; Brandt, Frans; Pedersen, Dorthe Almind
2013-01-01
Background: Although hypothyroidism is associated with increased morbidity, an association with increased mortality is still debated. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism influences mortality. Methods: In an observational cohort study from...... January 1, 1978 until December 31, 2008 using record-linkage data from nationwide Danish health registers, 3587 singletons and 682 twins diagnosed with hypothyroidism were identified. Hypothyroid individuals were matched 1:4 with nonhypothyroid controls with respect to age and gender and followed over...... a mean period of 5.6 years (range 0-30 years). The hazard ratio (HR) for mortality was calculated using Cox regression analyses. Comorbidity was evaluated using the Charlson score (CS). Results: In singletons with hypothyroidism, the mortality risk was increased (HR 1.52; 95% confidence interval [CI]: 1...
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Eating disorder beliefs and behaviours across eating disorder diagnoses.
Allan, Steven; Goss, Ken
2014-01-01
To test for differences between diagnostic groups on the severity of eating disorder beliefs and behaviours, evaluate the clinical significance of such differences, and assess the extent to which these beliefs and behaviours may be present at clinically significant levels across eating disorder diagnoses. 136 adult women outpatients (aged 18-65, with a BMI over 15) were diagnosed with an eating disorder and completed the Stirling Eating Disorder Scale. The expected pattern of statistically significant differences was found between diagnostic groups on anorexic dietary beliefs and behaviours and bulimic dietary beliefs and behaviours. A high percentage of participants in each diagnostic group scored above the clinical cut-off on the eating disorder belief and behaviour measures and a very high percentage of participants in each group reported clinically significant levels of restricting beliefs. Transdiagnostic or functional analytic approaches to treatment planning may lead to more effective interventions than current, diagnostically-based, care pathways. The high prevalence of restricting beliefs reported suggested that this may need to be a key focus for intervention for the majority of individuals presenting with an eating disorder. © 2013.
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Chinese version of the separation-individuation inventory.
Tam, Wai-Cheong Carl; Shiah, Yung-Jong; Chiang, Shih-Kuang
2003-08-01
The importance of the separation-individuation process in object relations theory is well known in disciplines of psychology, counseling, and human development. Based on the Separation-Individuation Inventory of Christenson and Wilson, which measures the manifestations of disturbances in this process, a Chinese version of the inventory was developed. For college students Cronbach coefficient alpha was .89, and test-retest reliability over 28 days was .77. The scores of the inventory had positive correlations with both the number of borderline personality characteristics and the Individualism-Collectivism Scale, respectively. Also, the mean score on the inventory of patients diagnosed with borderline personality disorder was significantly higher than that of the two normal control groups (ns = 564). Thus the inventory possessed satisfactory construct validity. Cultural differences regarding the separation-individuation process need to be investigated further.
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Coming Together to Calm the Hunger: Group Therapy Program for Adults Diagnosed with Anorexia Nervosa
Ponech, Heather; McBride, Dawn Lorraine
2012-01-01
This project provides a comprehensive overview of the research literature on anorexia nervosa in female adults and concludes by offering 14 group therapy lesson plans for anorexia nervosa that therapists may use in their practice. There is a remarkable lack of research on the efficacy of treatment designed for individuals diagnosed with anorexia…
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Ohrstrom, Peter
2011-01-01
The HANDS (Helping Autism-diagnosed teenagers Navigate and Develop Socially) research project involves the creation of an e-learning toolset that can be used to develop individualized tools to support the social development of teenagers with an autism diagnosis. The e-learning toolset is based on ideas from persuasive technology. This paper…
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DEFF Research Database (Denmark)
Hønge, Bo Langhoff; Bjarnason Obinah, Magnús Pétur; Jespersen, Sanne
2014-01-01
As HIV-2 is intrinsically resistant to nonnucleoside reverse transcriptase inhibitors, it is mandatory to discriminate between HIV types before initiating antiretroviral treatment. Guinea-Bissau has the world's highest prevalence of HIV-2 and HIV-1/HIV-2 dually infected individuals. We evaluated ...... (agreement 90.9%) and SD Bioline HIV-1/2 3.0 (agreement 84.5%). Our results underscore the need for evaluation of tests in relevant populations before implementation....
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Darling, Meghan; Huber, Jessica E.
2011-01-01
Purpose: Individuals with Parkinson's disease (PD) exhibit differences in displacement and velocity of the articulators as compared with older adults. The purpose of the current study was to examine effects of 3 loudness cues on articulatory movement patterns in individuals with PD. Method: Nine individuals diagnosed with idiopathic PD and 9 age-…
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Directory of Open Access Journals (Sweden)
Lund JL
2013-12-01
Full Text Available Jennifer L Lund,1 Suzanne F Cook,2 Jeffery K Allen,2 Charlotte F Carroll,2 Michael D Kappelman3 1Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark; 2Worldwide Epidemiology, GlaxoSmithKline, Research Triangle Park, NC, USA; 3Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Background and aims: Thiopurines, including 6-mercaptopurine (6-MP and azathioprine (AZA, are the mainstay of maintenance therapy for Crohn's disease (CD. However, studies examining their effectiveness in routine practice among diverse patient populations are lacking. Among a cohort of new users of 6MP/AZA, we described treatment patterns and changes in subsequent therapy. Methods: Using the Truven Health Analytics databases, we identified all individuals diagnosed with CD and initiating 6-MP/AZA monotherapy from 2001–2008 (n=3,657. We estimated the proportion of CD patients remaining on 6-MP/AZA monotherapy, using Kaplan–Meier methods, and identified predictors of treatment noncontinuation, using multivariable Cox regression. Among the “noncontinuers,” we described subsequent patterns of maintenance therapy and summarized the diagnosis and procedure codes and prescription drug claims preceding treatment discontinuation. Results: The 1-year 6-MP/AZA treatment continuation rate was 42%. Children (age ≤18 years and individuals with no prior anti-tumor necrosis factor (TNF use were more likely to continue 6-MP/AZA, while those dispensed more (>4 outpatient prescriptions for any drug before initiation of 6-MP/AZA were less likely to continue maintenance treatment. Overall, 1,128 (39% and 105 (4% individuals experienced a clinical event potentially indicating active disease or 6-MP/AZA-intolerance prior to discontinuation, respectively. Most patients discontinued therapy; among the remaining patients who failed to continue 6-MP/AZA, most augmented with an anti-TNF. Conclusion: Most patients initiating 6-MP
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The Multi-faceted Implementation of Telepractice to Service Individuals with Autism
Directory of Open Access Journals (Sweden)
Michelle Boisvert
2012-12-01
Full Text Available Telepractice is a method of service delivery in which professionals provide intervention, assessment and consultation services to individuals through the use of telecommunication technologies. In response to the nationwide school-based shortage of speech-language pathologists, telepractice has emerged as a viable way to reach underserved clients. Telepractice has the potential to extend to populations in need of services, including those diagnosed with autism. This paper examines an evidence-based clinical model for the delivery of telepractice services and describes the policies and procedures required for assessing individual need, confidentiality, technology, training and documentation within a telepractice program. Two clinical case studies involving individuals diagnosed with autism are described and provide initial evidence for the use of telepractice as a practical method for direct and consultative service delivery. Results indicated that both the student receiving direct services, and the treating clinician receiving consultative services via telepractice, demonstrated an increased skill level in target domains.
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Cochlear Implants in Children Diagnosed with CHARGE Syndrome
Directory of Open Access Journals (Sweden)
Cardoso, Carolina Costa
2013-09-01
Full Text Available Introduction: The CHARGE association (coloboma of the eyes; heart disease; atresia of the choanae; retarded growth and development; genital hypoplasia/genitourinary anomalies; ear anomalies and/or hearing loss was first described in 1979 by Hall, and among its main features is hearing loss. This study presents a case aiming to establish relationships between performance on Infant Toddler Meaningful Auditory Integration Scale (IT-MAIS and Meaningful Use of Speech Scales (MUSS tests and the analysis of hearing and language categories of a patient diagnosed with CHARGE syndrome, before and after cochlear implant (CI surgery. Case Report: A 7-year-old girl was diagnosed with CHARGE. She had severe sensorineural hearing loss and was a prelingual unilateral CI user. We analyzed data from the patient's medical records regarding therapies and video recordings. Results: The patient showed positive results in all evaluations after CI. IT-MAIS rose from 5 to 90% following the use of CI. MUSS also rose, from 75 to 72.5%, after use of CI. Classification of Auditory Skills changed from category 1 before use of CI to category 6 after use of CI. Classification of Language Skills changed from category 1 before use of CI to category 3 after use of CI. The CI is an aid but there are many factors in the therapeutic process, and great heterogeneity in individuals diagnosed with CHARGE should be investigated. Conclusion: The development of listening and language skills after CI use was demonstrated by IT-MAIS and MUSS tests, and categorization of speech and hearing in this child with a diagnosis of CHARGE syndrome shows that CI can be an effective technological resource to provide information on hearing as one source for language construction.
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Are we diagnosing too many people with coeliac disease?
Aziz, Imran; Sanders, David S
2012-11-01
This review will try to address the question of whether we are diagnosing too many people with coeliac disease. The key reasons for diagnosing coeliac disease may be that it is a common condition affecting up to 1% of the adult population. Delays in diagnosis are common. The average time delay reported by Coeliac UK (National Medical Patient Charity), for patients with symptoms prior to the diagnosis being made is 13 years. For every adult case detected, it is estimated that there are eight cases not detected. Patients with coeliac disease have an associated morbidity and mortality. In addition, quality of life studies suggest that the majority of patients benefit from a gluten-free diet (GFD). Furthermore, the GFD reduces or alleviates the risk of the associated complications. All of these facts could even be used to support the argument for screening! However, conversely the tests for coeliac disease are not 100% sensitive and specific. In addition, we do not know whether patients with milder symptoms will derive less benefit from treatment and are at less risk of complications. Furthermore, evidence presented in this review suggests that actual outcomes for screening studies in an adult population have revealed poor uptake and subsequently difficulties with adherence. What little published data that are available also infers that individuals recognised through screening programmes could have been detected if carefully questioned for symptoms. There is evidence to suggest that diagnosing celiac disease is cost-effective and that the diagnostic costs are offset by reduced medical expenditures, reduced hospital and general practice attendances, but this view depends on the population prevalence of coeliac disease. We believe on the basis of the evidence presented in this review that we are not diagnosing too many adults with coeliac disease. However, the authors consider case-finding with a low threshold for serological testing to be the optimal approach. If you
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DEFF Research Database (Denmark)
Mertz, Birgitte Goldschmidt; Dunn-Henriksen, Anne Katrine; Kroman, Niels
2017-01-01
AIM: Our aim was to determine the feasibility and effectiveness of an individual, nurse-navigator intervention for relieving distress, anxiety, depression and health-related quality of life in women who have been treated for breast cancer (BC) and are experiencing moderate-to-severe psychological...... and the secondary outcomes were anxiety, depression, health-related quality of life and feasibility of the intervention. RESULTS: Women in the intervention group reported significantly greater satisfaction with treatment and rehabilitation and lower levels of distress (mean 2.7 vs. 5.1, p.... 7.8, p = .02) and depression (mean 2.2 vs. 4.4, p = .04) after 12 months compared to the control group. No significant effects were seen on health-related quality of life. CONCLUSIONS: The study shows promising feasibility of the individually tailored nurse-navigation intervention and while...
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Hyponatremia, all-cause mortality, and risk of cancer diagnoses in the primary care setting
DEFF Research Database (Denmark)
Selmer, Christian; Madsen, Jesper Clausager; Torp-Pedersen, Christian
2016-01-01
BACKGROUND: Hyponatremia has been associated with increased all-cause mortality in hospitalized individuals. In this study we examine the risk of all-cause mortality in primary care subjects with hyponatremia, while also exploring the association with subsequent diagnosis of cancer. METHODS...... was all-cause mortality, and secondary outcomes overall and specific types of cancer diagnoses. RESULTS: Among 625,114 included subjects (mean age 49.9 [SD±18.4] years; 43.5% males), 90,926 (14.5%) deaths occurred. All-cause mortality was increased in mild, moderate, and severe hyponatremia (age...... of hyponatremia are associated with all-cause mortality in primary care patients and hyponatremia is linked to an increased risk of being diagnosed with any cancer, particularly pulmonary and head and neck cancers....
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Diagnosing Diabetes and Learning about Prediabetes
... Listen En Español Diagnosing Diabetes and Learning About Prediabetes There are several ways to diagnose diabetes. Each ... or equal to 200 mg/dl What is Prediabetes? Before people develop type 2 diabetes, they almost ...
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The Consistency Between Clinical and Electrophysiological Diagnoses
Directory of Open Access Journals (Sweden)
Esra E. Okuyucu
2009-09-01
Full Text Available OBJECTIVE: The aim of this study was to provide information concerning the impact of electrophysiological tests in the clinical management and diagnosis of patients, and to evaluate the consistency between referring clinical diagnoses and electrophysiological diagnoses. METHODS: The study included 957 patients referred to the electroneuromyography (ENMG laboratory from different clinics with different clinical diagnoses in 2008. Demographic data, referring clinical diagnoses, the clinics where the requests wanted, and diagnoses after ENMG testing were recorded and statistically evaluated. RESULTS: In all, 957 patients [644 (67.3% female and 313 (32.7% male] were included in the study. Mean age of the patients was 45.40 ± 14.54 years. ENMG requests were made by different specialists; 578 (60.4% patients were referred by neurologists, 122 (12.8% by orthopedics, 140 (14.6% by neurosurgeons, and 117 (12.2% by physical treatment and rehabilitation departments. According to the results of ENMG testing, 513 (53.6% patients’ referrals were related to their referral diagnosis, whereas 397 (41.5% patients had normal ENMG test results, and 47 (4.9% patients had a diagnosis that differed from the referring diagnosis. Among the relation between the referral diagnosis and electrophysiological diagnosis according to the clinics where the requests were made, there was no statistical difference (p= 0.794, but there were statistically significant differences between the support of different clinical diagnoses, such as carpal tunnel syndrome, polyneuropathy, radiculopathy-plexopathy, entrapment neuropathy, and myopathy based on ENMG test results (p< 0.001. CONCLUSION: ENMG is a frequently used neurological examination. As such, referrals for ENMG can be made to either support the referring diagnosis or to exclude other diagnoses. This may explain the inconsistency between clinical referring diagnoses and diagnoses following ENMG
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DEFF Research Database (Denmark)
Scott, James G; Giørtz Pedersen, Marianne; Erskine, Holly E
2017-01-01
by specialist services were followed from their first birthday to 2013. Those with and without DBDs were compared using mortality rate ratios (MRRs) estimated using Poisson regression and adjusted for calendar period, age, sex, family history of psychiatric disorders, maternal age at time of birth, paternal age...... at time of birth, parental education status, and parental employment status. Over the course of follow up, which totalled 24.9 million person-years, 5580 cohort members died including 78 individuals with DBDs. The mortality rate per 10,000 person-years was 9.66 for individuals with DBDs compared to 2...
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Klijs, Bart; Nusselder, Wilma J.; Mackenbach, Johan P.
Objectives: To investigate to what extent underlying and multiple causes of death represent end-of-life morbidity in individuals and at population level. Study Design and Setting: Cause of death and national hospital data were individually linked for all deaths at the age of 50-84 years, in 2005 in
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Diagnosing suffering: a perspective.
Cassell, E J
1999-10-05
The alleviation of suffering is crucial in all of medicine, especially in the care of the dying. Suffering cannot be treated unless it is recognized and diagnosed. Suffering involves some symptom or process that threatens the patient because of fear, the meaning of the symptom, and concerns about the future. The meanings and the fear are personal and individual, so that even if two patients have the same symptoms, their suffering would be different. The complex techniques and methods that physicians usually use to make a diagnosis, however, are aimed at the body rather than the person. The diagnosis of suffering is therefore often missed, even in severe illness and even when it stares physicians in the face. A high index of suspicion must be maintained in the presence of serious disease, and patients must be directly questioned. Concerns over the discomfort of listening to patients' severe distress are usually more than offset by the gratification that follows the intervention. Often, questioning and attentive listening, which take little time, are in themselves ameliorative. The information on which the assessment of suffering is based is subjective; this may pose difficulties for physicians, who tend to value objective findings more highly and see a conflict between the two kinds of information. Recent advances in understanding how physicians increase the utility of information and make inferences allow one to reliably use the subjective information on which the diagnosis and treatment of suffering depend. Knowing patients as individual persons well enough to understand the origin of their suffering and ultimately its best treatment requires methods of empathic attentiveness and nondiscursive thinking that can be learned and taught. The relief of suffering depends on physicians acquiring these skills.
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Directory of Open Access Journals (Sweden)
Andressa Carioca Bezerra
2016-12-01
Full Text Available The objective was to characterize the profile of nursing diagnoses of the domains Self-perception and Coping/Tolerance of stress of women with infertility complaints. A descriptive, quantitative study conducted with 40 women, in a primary health care unit. Data was collected with an interview form created for this study. We identified 20 diagnoses. Improved readiness for power, Improved readiness for coping, Improved readiness for resilience, Anxiety and, Low situational self-esteem presented were more frequent. The findings revealed that infertility can generate anxiety and negatively affect women’s self-perception. However, this clientele demonstrated readiness to optimize their wellbeing. Identification of diagnoses contributes with care planning and enriches the quality of assistance, allowing women to be prepared for achieving maternity or not, through individualized nursing interventions, including emotional and psychosocial support according to the need of each one of them.
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DEFF Research Database (Denmark)
Olesen, Birgitte Ravn; Jansbøl, Kirsten
I dette hæfte ligger fokus på døvblindblevnes fortællinger om at have et handicap uden at kende sin diagnose og om at håndtre at få diagnosen RP eller Usher syndrom. Det er karakteristisk for fortællingerne, at det har stor betydning - hvornår i livet, man får sin diagnose - under hvilke...
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CT-MPR invaluable in diagnosing odontogenic maxillary sinusitis
International Nuclear Information System (INIS)
Aoki, Hideaki; Shimazu, Kaoru; Kamada, Morito; Shiroyama, Akihiro; Mouri, Daisuke; Yamashita, Masashi; Kawasaki, Yasunori; Koseki, Takakazu; Mouri, Manabu
2001-01-01
In everyday examination, it is usual to encounter odontogenic maxillary sinusitis patients. Odontogenic maxillary sinusitis is generally best diagnosed by dental X-ray imaging. Many medical facilities not having a dental X-ray unit use coronal computed tomography (CT) images to diagnose odontogenic maxillary sinusitis. Coronal CT imaging causes artifacts, however due to dental prosthesises. Computed tomography-Multiplanar reformation (CT-MPR) imaging has proved useful in evaluating the paranasal sinus because it is not influenced by dental prosthesises. We evaluated the usefulness of CT-MPR for diagnosing odontogenic maxillary sinusitis by retrospectively analyzing 16 patients, with the following results. We couldn't diagnose all cases of odontogenic maxillary sinusitis in posteroanterior and Waters projection images. Panoramic radiography is needed to diagnose odontogenic maxillary sinusitis. Dental X-ray imaging missed some cases, but all cases were diagnosed by CT-MPR imaging, giving a 100% diagnosestic rate. CT-MPR imaging is thus at least as valuable or better than dental X-ray imaging in diagnosing odontogenic maxillary sinusitis. (author)
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Validation studies of nursing diagnoses in neonatology
Directory of Open Access Journals (Sweden)
Pavlína Rabasová
2016-03-01
Full Text Available Aim: The objective of the review was the analysis of Czech and foreign literature sources and professional periodicals to obtain a relevant comprehensive overview of validation studies of nursing diagnoses in neonatology. Design: Review. Methods: The selection criterion was studies concerning the validation of nursing diagnoses in neonatology. To obtain data from relevant sources, the licensed professional databases EBSCO, Web of Science and Scopus were utilized. The search criteria were: date of publication - unlimited; academic periodicals - full text; peer-reviewed periodicals; search language - English, Czech and Slovak. Results: A total of 788 studies were found. Only 5 studies were eligible for content analysis, dealing specifically with validation of nursing diagnoses in neonatology. The analysis of the retrieved studies suggests that authors are most often concerned with identifying the defining characteristics of nursing diagnoses applicable to both the mother (parents and the newborn. The diagnoses were validated in the domains Role Relationship; Coping/Stress tolerance; Activity/Rest, and Elimination and Exchange. Diagnoses represented were from the field of dysfunctional physical needs as well as the field of psychosocial and spiritual needs. The diagnoses were as follows: Parental role conflict (00064; Impaired parenting (00056; Grieving (00136; Ineffective breathing pattern (00032; Impaired gas exchange (00030; and Impaired spontaneous ventilation (00033. Conclusion: Validation studies enable effective planning of interventions with measurable results and support clinical nursing practice.
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King, Jessica E; Plamondon, Jenna; Counts, Debra; Laney, Dawn; Dixon, Shannan DeLany
2016-02-01
Delayed discussion about infertility with individuals affected by Turner syndrome (TS) has been found to result in psychological and social harm. The aim of this study was to identify barriers experienced when discussing infertility and determine resource types that may facilitate this conversation. An electronic survey, given to caregivers of girls with TS diagnosed at barriers in having the conversation. Although most individuals did not use resources to facilitate the conversation, they did express interest in additional resources.
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The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations
DEFF Research Database (Denmark)
Exarchou, Sofia; Lindström, Ulf; Askling, Johan
2015-01-01
-economic factors, and according to subgroups with ankylosing spondylitis-related clinical manifestations and pharmacological treatment. METHODS: All individuals diagnosed with ankylosing spondylitis according to the World Health Organization International Classification of Disease codes, between 1967 and 2009......, were identified from the National Patient Register. Data regarding disease manifestations, patient demographics, level of education, pharmacological treatment, and geographical region were retrieved from the National Patient Register and other national registers. RESULTS: A total of 11,030 cases...... prevalence of ankylosing spondylitis (0.23% versus 0.14%, P uveitis (25.5% versus 20.0%, P
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Risk of Psychiatric Disorders Among Individuals With the 22q11.2 Deletion or Duplication
DEFF Research Database (Denmark)
Hoeffding, Louise K; Trabjerg, Betina B; Olsen, Line
2017-01-01
) age at diagnosis of any psychiatric disorder was 12.5 (8.3) years for individuals with deletions and 6.1 (0.9) years for duplication carriers. A parental diagnosis of schizophrenia-but not of other psychiatric diagnoses-was associated with a 22q11.2 deletion, and parental psychiatric diagnoses other.......2 deletion or duplicationwas performed. A total of 3 768 943 individuals born in Denmark from 1955 to 2012 were followed up during the study period (total follow-up, 57.1 million person-years). Indicators of 22q11.2 deletion or duplication and cumulative incidenceswere estimated using a nested case...
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Nursing diagnoses in overweight adolescents
Directory of Open Access Journals (Sweden)
Raphaela Santos do Nascimento Rodrigues
2013-05-01
Full Text Available This study aimed to identify nursing diagnoses in overweight adolescents from public schools, according to the International Classification for Nursing Practice. A population-based cross-sectional study that investigated the socio-demographic, behavioural and psychological characteristics of adolescents aged from 10 to 14 years. 11 nursing diagnoses were identified: "Risk of overweight", "Risk of impaired adolescent development", "Risk of insecurity in parental role performance", "Risk of the family impaired ability to manage diet regime", "Risk of impaired ability to manage diet regime", "Risk of lack of knowledge of dietary regime", "Risk of excess food intake", "Risk of negative self-image", "Risk of low self-esteem", "Risk of impaired social well-being" and "Impaired exercise pattern". These diagnoses reflect the multifactorial nature of obesity, highlighting the need for interdisciplinary and intersectoral articulation of nursing interventions for prevention and control of overweight.
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Gaucher's disease diagnosed by splenectomy.
Adas, Mine; Adas, Gokhan; Karatepe, Oguzhan; Altiok, Merih; Ozcan, Deniz
2009-08-01
Splenectomy continues to find common therapeutic indications for hematologic disorders. In addition, recently it is also performed in surgical clinics to assist diagnose of some illnesses. Gaucher's disease, especially Type I, is the most frequently encountered lysosomal storage disorder in man. Manifestations of it are highly variable. The most frequently found symptoms include splenomegaly with anaemia and thrombocytopenia, mostly due to hypersplenism, hepatomegaly and bone disease. Four patients were reported in the present study. Three of them were easily diagnosed with Gaucher's disease via bone marrow cytology, and one with Gaucher's disease was detected by pathological examination following the splenectomy. For the pouse of diagnosis of the Gaucher's disease, performing surgery is generally not necessary. However, for the cases of difficult to diagnose by classical methods, the corect diagnosis of Gaucher's disease can only be made by a special operation.
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Diagnosing differences between business process models
Dijkman, R.M.; Dumas, M.; Reichert, M.; Shan, M.-C.
2008-01-01
This paper presents a technique to diagnose differences between business process models in the EPC notation. The diagnosis returns the exact position of a difference in the business process models and diagnoses the type of a difference, using a typology of differences developed in previous work.
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How Do Health Care Providers Diagnose Cushing's Syndrome?
... Email Print How do health care providers diagnose Cushing syndrome? Diagnosing Cushing syndrome can be complex and difficult. This syndrome is ... health care provider may try different tests. Diagnosing Cushing syndrome often requires several steps. If you are being ...
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Art Therapy for an Individual with Late Stage Dementia: A Clinical Case Description
Tucknott-Cohen, Tisah; Ehresman, Crystal
2016-01-01
This article describes the healing benefits of art therapy for an individual with dementia of the Alzheimer's type. In this clinical case description, a woman diagnosed with Alzheimer's disease received individual art therapy for 17 weeks. The treatment concerns that arose, altered view of reality, agitation, and retrogenesis provide insight on…
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International Nuclear Information System (INIS)
Hofvind, S.; Skaane, P.
2012-01-01
Purpose: The German mammographic screening program is very similar to the Norwegian Breast Cancer Screening Program (NBCSP), which started about 10 years earlier. This study analyzes the stage distribution of invasive breast cancers diagnosed in the pre-screening and screening period, and evaluates the overall mortality in women aged 55 - 74 in the pilot and non-pilot counties of the NBCSP. Materials and Methods: The NBCSP invites women aged 50 - 69 to participate in two-view mammography biennially. Chi-square statistics were used to compare percentages of the stage and treatment of invasive breast cancers diagnosed in women residing in the four pilot counties in the pre-screening (1984 - 1995) and screening (1996 - 2007) period. An ecological approach was used to analyze the age-specific mortality in the pilot and non-pilot counties for the period 1970 - 2007. Results: 50 % of the breast cancers diagnosed in the pre-screening period, 70 % of the cases detected with screening, 43 % of the interval cancers, and 52 % of the cancers diagnosed outside the NBCSP were stage I. Stage III + was present in 11 % of the cancers in the pre-screening period, and in 1 % of the cancers detected with screening. In the screening period, the breast cancer mortality rate decreased substantially more in the pilot counties than in the non-pilot counties. Conclusion: The stage distribution of breast cancer diagnosed in the NBCSP is prognostically favorable compared to cancers diagnosed outside the screening program. The reduction in the breast cancer mortality rate was more pronounced in the four pilot counties compared to the non-pilot counties. It is necessary to evaluate the program based on individual data. (orig.)
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available ... You are here Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation for Children Diagnosed with Cancer Ask Your Doctor Information for ...
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available ... Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult ...
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Psychiatric diagnoses, trauma, and suicidiality
Directory of Open Access Journals (Sweden)
Elklit Ask
2007-04-01
Full Text Available Abstract Background This study aimed to examine the associations between psychiatric diagnoses, trauma and suicidiality in psychiatric patients at intake. Methods During two months, all consecutive patients (n = 139 in a psychiatric hospital in Western Norway were interviewed (response rate 72%. Results Ninety-one percent had been exposed to at least one trauma; 69 percent had been repeatedly exposed to trauma for longer periods of time. Only 7% acquired a PTSD diagnosis. The comorbidity of PTSD and other psychiatric diagnoses were 78%. A number of diagnoses were associated with specific traumas. Sixty-seven percent of the patients reported suicidal thoughts in the month prior to intake; thirty-one percent had attempted suicide in the preceding week. Suicidal ideation, self-harming behaviour, and suicide attempts were associated with specific traumas. Conclusion Traumatised patients appear to be under- or misdiagnosed which could have an impact on the efficiency of treatment.
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Strickland, Karen; Worth, Allison; Kennedy, Catriona
2017-06-01
To explore the lived experience of the meaning of being diagnosed with multiple sclerosis on the individual's sense of self. The time leading up to and immediately following the diagnosis of multiple sclerosis has been identified as a time period shrouded by uncertainty and one where individuals have a heightened desire to seek accurate information and support. The diagnosis brings changes to the way one views the self which has consequences for biographical construction. A hermeneutic phenomenological study. In-depth qualitative interviews were conducted with 10 people recently diagnosed with multiple sclerosis. The data were analysed using interpretative phenomenological analysis. This study presents the three master themes: the 'road to diagnosis', 'the liminal self' and 'learning to live with multiple sclerosis'. The diagnosis of multiple sclerosis may be conceptualised as a 'threshold moment' where the individual's sense of self is disrupted from the former taken-for-granted way of being and propose a framework which articulates the transition. The findings highlight the need for healthcare professionals to develop interventions to better support people affected by a new diagnosis of multiple sclerosis. The conceptual framework which has been developed from the data and presented in this study provides a new way of understanding the impact of the diagnosis on the individual's sense of self when affected by a new diagnosis of multiple sclerosis. This framework can guide healthcare professionals in the provision of supportive care around the time of diagnosis. The findings provide practitioners with a new way of understanding the impact of the diagnosis on the individual's sense of self and a framework which can guide them in the provision of supportive care around the time of diagnosis. © 2016 John Wiley & Sons Ltd.
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Diabetes education improves depressive state in newly diagnosed patients with type 2 diabetes
Chen, Bin; Zhang, Xiyao; Xu, Xiuping; Lv, Xiaofeng; Yao, Lu; Huang, Xu; Guo, Xueying; Liu, Baozhu; Li, Qiang; Cui, Can
2013-01-01
Objectives: The prevalence of depression is relatively high in individuals with diabetes. However, screening and monitoring of depressive state in patients with diabetes is still neglected in developing countries and the treatment of diabetes-related depression is rarely performed in these countries. In this study, our aim was to study the role of diabetes education in the improvement of depressive state in newly diagnosed patients with type 2 diabetes. Methods: The Dutch version of the cente...
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Difficult diagnoses in the skeletal radiology
International Nuclear Information System (INIS)
Freyschmidt, Juergen
2013-01-01
The book on difficult diagnoses in the skeletal radiology discusses the path from symptom to diagnoses including image interpretation. Specific case studies concern the skull, the spinal cord, pelvis, shoulder and chest, upper and lower extremities. The used radiological techniques include projecting radiography, computerized tomography, scintiscanning, PET/CT, NNR imaging and ultrasonography.
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Ирина Александровна Карпезина
2009-01-01
Preparation of pupils with health infringements in sanatorium type schools is carried out by individual techniques. In article approaches to diagnosing of schoolboys for a choice of individual trajectories of training to informatics are considered.
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Kessler, Ronald C.; Avenevoli, Shelli; Green, Jennifer; Gruber, Michael J.; Guyer, Margaret; He, Yulei; Jin, Robert; Kaufman, Joan; Sampson, Nancy A.; Zaslavsky, Alan M.; Merikangas, Kathleen R.
2009-01-01
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnoses that was based on the World Health Organization's Composite International Diagnostic Interview (CIDI) and implemented in the National comorbidity survey replication adolescent supplement is found to have good individual-level concordance with diagnosis based on blinded…
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Edwards, Darren J; Wood, Rodger
2016-01-01
This study explored over-selectivity (executive dysfunction) using a standard unsupervised categorization task. Over-selectivity has been demonstrated using supervised categorization procedures (where training is given); however, little has been done in the way of unsupervised categorization (without training). A standard unsupervised categorization task was used to assess levels of over-selectivity in a traumatic brain injury (TBI) population. Individuals with TBI were selected from the Tertiary Traumatic Brain Injury Clinic at Swansea University and were asked to categorize two-dimensional items (pictures on cards), into groups that they felt were most intuitive, and without any learning (feedback from experimenter). This was compared against categories made by a control group for the same task. The findings of this study demonstrate that individuals with TBI had deficits for both easy and difficult categorization sets, as indicated by a larger amount of one-dimensional sorting compared to control participants. Deficits were significantly greater for the easy condition. The implications of these findings are discussed in the context of over-selectivity, and the processes that underlie this deficit. Also, the implications for using this procedure as a screening measure for over-selectivity in TBI are discussed.
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Swimming-induced pulmonary oedema an uncommon condition diagnosed with POCUS ultrasound.
Alonso, Joaquín Valle; Chowdhury, Motiur; Borakati, Raju; Gankande, Upali
2017-12-01
Swimming Induced Pulmonary Edema, or SIPE, is an emerging condition occurring in otherwise healthy individuals during surface swimming or diving that is characterized by cough, dyspnea, hemoptysis, and hypoxemia. It is typically found in those who spend time in cold water exercise with heavy swimming and surface swimming, such as civilian training for iron Man, triathalon, and military training. We report the case of a highly trained young female swimmer in excellent cardiopulmonary health, who developed acute alveolar pulmonary oedema in an open water swimming training diagnosed in the emergency department using POCUS ultrasound. Copyright © 2017 Elsevier Inc. All rights reserved.
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Nursing diagnoses determined by first year students: a vignette study.
Hakverdioğlu Yönt, Gülendam; Korhan, Esra Akın; Erdemir, Firdevs; Müller-Staub, Maria
2014-02-01
The study aimed to determine the ability of first year students in identifying nursing diagnoses. In a descriptive evaluation study, an expert-validated vignette containing 18 nursing diagnoses was used. The students determined 15 nursing diagnoses. The highest percentages of diagnoses identified were disturbed sleep pattern and nutrition imbalance. Students also considered medical diagnoses as nursing diagnoses: hypertension and tachycardia. Despite the fact that students were only at the end of their first semester and had limited clinical experience, they successfully identified the majority of nursing diagnoses. Patient case study vignettes are recommended for education. To foster students' knowledge and experience, it is also suggested that evaluating nursing diagnoses in clinical practicals becomes a requirement. © 2013 NANDA International, Inc.
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Balbino, K P; Epifânio, A P S; Ribeiro, S M R; da Silva, L D M; Gouvea, M G; Hermsdorff, H H M
2017-10-01
The present study aimed to evaluate the nutritional status of patients undergoing haemodialysis (HD) by comparing nutritional risk scores with biochemical, anthropometric and body composition variables. Eighty-five individuals [65.9% male, mean (SD) age 62 (14) years] participated in a cross-sectional study. Global Objective Assessment (GOA) and Modified Global Subjective Assessment (mGSA) scores, as well as biochemical, anthropometric and body composition data, were collected using standardised procedures. The prevalence of malnutrition ranged from 20.0% (% body fat by electrical bioimpedance) to 95.3% (by GOA), depending on the indicator or score used. According to the waist circumference, 61.2% of the individuals presented abdominal obesity and visceral adipose tissue was excessive in 20% of them. Malnutrition diagnosis by GOA showed the relationship between the anthropometric and body composition indicators, as assessed by the extent that the ratings of risk nutritional/mild malnutrition and mainly moderate malnutrition were accompanied by a significant decrease in nutritional status and body composition variables. However, with respect to categories of mGSA, no statistically significant differences were observed for nutritional status and body composition variables. In the receiver operator characteristic curve analyses, mGSA and GOA were good indicators for diagnosing malnutrition because both achieved an AUC > 0.5. mGSA and GOA were more sensitive with respect to identifying individuals at nutritional risk compared to the isolated anthropometric indicators, thus indicating their utility in diagnostic malnutrition. However, individuals at high nutritional risk also presented cardiometabolic risk, as diagnosed mainly by central fat indicators, suggesting the application of both malnutrition and cardiometabolic risk markers in HD patients. © 2017 The British Dietetic Association Ltd.
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Directory of Open Access Journals (Sweden)
Ирина Александровна Карпезина
2009-06-01
Full Text Available Preparation of pupils with health infringements in sanatorium type schools is carried out by individual techniques. In article approaches to diagnosing of schoolboys for a choice of individual trajectories of training to informatics are considered.
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Castetbon, Katia; Bonaldi, Christophe; Deschamps, Valérie; Vernay, Michel; Malon, Aurélie; Salanave, Benoit; Druet, Céline
2014-06-01
A healthy diet has been shown to prevent diabetes complications. However, the eating habits of individuals with diabetes who are aware of their glycemic condition have been poorly studied. This study's objective was to assess the dietary behavior overall and according to dietary recommendations in adults diagnosed with diabetes compared with those of a general population of the same age (45 to 74 years) in a nationally representative survey carried out in France in 2006-2007 (Etude Nationale Nutrition Santé) (n=1,476 including 101 patients with diabetes). Trained dietitians assessed diet using three 24-hour recalls and diabetes was self-declared. After weighting and using multiple adjustments, mean food and nutrient intakes were compared according to diabetes status. Interactions with age and sex were sought. Adults with diabetes had lower intakes of sweetened foods (40 g/day vs 125 g/day), alcohol (1.45 g/day vs 1.64 g/day), energy (1,790 kcal/day vs 1,986 kcal/day), and simple sugar (63.1 g/day vs 89.8 g/day) and higher intakes of meat (126 g/day vs 109 g/day), complex carbohydrates (26.3% energy intake vs 23.6% energy intake), and vitamins B and E (628 μg/day vs 541 μg/day). In addition, 45- to 59-year-old individuals with diabetes ate more fruits and vegetables, fiber, beta carotene, folate, vitamin C, and potassium than adults of the same age who did not have diabetes. Overall, 45- to 74-year-old adults with diabetes had a higher-quality diet than individuals without diabetes. However, compared with recommendations, a healthy diet continues to represent a public health challenge in terms of preventing diabetes complications. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
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DEFF Research Database (Denmark)
Munkner, R; Haastrup, S; Jørgensen, T
2003-01-01
with schizophrenia born after November 1, 1963, data on criminality, substance-related diagnoses and contacts with the psychiatric hospital system were analysed. RESULTS: Compared with the non-convicted schizophrenics the convicted were older on first contact with the psychiatric hospital system and older when...... are aware of possible psychotic symptoms in criminal and abusing individuals to enable earlier detection and treatment....
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Queer diagnoses revisited: The past and future of homosexuality and gender diagnoses in DSM and ICD.
Drescher, Jack
2015-01-01
The American Psychiatric Association (APA) recently completed a several year process of revising the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). During that time, there were objections raised to retaining DSM's gender identity disorder diagnoses and calls to remove them, just as homosexuality had been removed from DSM-II in 1973. At the conclusion of the DSM-5 revision process, the gender diagnoses were retained, albeit in altered form and bearing the new name of 'gender dysphoria'. The author of this paper was a member of the DSM-5 Workgroup on Sexual and Gender Identity Disorders and presently serves on the WHO Working Group on Sexual Disorders and Sexual Health. Both groups faced similar tasks: reconciling patients' needs for access to care with the stigma of being given a psychiatric diagnosis. The differing nature of the two diagnostic manuals led to two different outcomes. As background, this paper updates the history of homosexuality and the gender diagnoses in the DSM and in the International Statistical Classification of Diseases and Related Health Problems (ICD) as well as what is expected to happen to the homosexuality and gender diagnoses following the current ICD-11 revision process.
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Directory of Open Access Journals (Sweden)
Ellenor Mittendorfer-Rutz
Full Text Available BACKGROUND: Despite the magnitude and increase of sickness absence due to mental diagnoses, little is known regarding long-term health outcomes. The aim of this nationwide population-based, prospective cohort study was to investigate the association between sickness absence due to specific mental diagnoses and the risk of all-cause and cause-specific mortality. METHODS: A cohort of all 4 857 943 individuals living in Sweden on 31.12.2004 (aged 16-64 years, not sickness absent, or on retirement or disability pension, was followed from 01.01.2005 through 31.12.2008 for all-cause and cause-specific mortality (suicide, cancer, circulatory disease through linkage of individual register data. Individuals with at least one new sick-leave spell with a mental diagnosis in 2005 were compared to individuals with no sickness absence. Hazard ratios (HR and 95% confidence intervals (CI were estimated by Cox regression, adjusting for age, sex, education, country of birth, family situation, area of residence, and pre-existing morbidity (diagnosis-specific hospital inpatient (2000-2005 and outpatient (2001-2005 care. RESULTS: In the multivariate analyses, mental sickness absence in 2005 was associated with an increased risk for all-cause mortality: HR: 1.65, 95% CI: 1.47-1.86 in women and in men: 1.73, 1.57-1.91; for suicide, cancer (both smoking and non-smoking related as well as mortality due to circulatory disease only in men. Estimates for cause-specific mortality ranged from 1.48 to 3.37. Associations with all-cause mortality were found for all mental sickness absence diagnostic groups studied. CONCLUSIONS: Knowledge about the prognosis of patients sickness absent with specific mental diagnoses is of crucial clinical importance in health care. Sickness absence due to specific mental diagnoses may here be used as a risk indictor for subsequent mortality.
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available ... website. Skip to main content SaveMyFertility An Online Fertility Preservation Toolkit for Patients and Their Providers Open ... Diagnosed with Cancer You are here Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation ...
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Immunoparesis in newly diagnosed Multiple Myeloma patients
DEFF Research Database (Denmark)
Sorrig, Rasmus; Klausen, Tobias W.; Salomo, Morten
2017-01-01
Immunoparesis (hypogammaglobulinemia) is associated to an unfavorable prognosis in newly diagnosed Multiple myeloma (MM) patients. However, this finding has not been validated in an unselected population-based cohort. We analyzed 2558 newly diagnosed MM patients in the Danish Multiple Myeloma...
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Empowering Mayo Clinic Individualized Medicine with Genomic Data Warehousing
Directory of Open Access Journals (Sweden)
Iain Horton
2017-08-01
Full Text Available Individualized medicine enables better diagnoses and treatment decisions for patients and promotes research in understanding the molecular underpinnings of disease. Linking individual patient’s genomic and molecular information with their clinical phenotypes is crucial to these efforts. To address this need, the Center for Individualized Medicine at Mayo Clinic has implemented a genomic data warehouse and a workflow management system to bring data from institutional electronic health records and genomic sequencing data from both clinical and research bioinformatics sources into the warehouse. The system is the foundation for Mayo Clinic to build a suite of tools and interfaces to support various clinical and research use cases. The genomic data warehouse is positioned to play a key role in enhancing the research capabilities and advancing individualized patient care at Mayo Clinic.
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Empowering Mayo Clinic Individualized Medicine with Genomic Data Warehousing.
Horton, Iain; Lin, Yaxiong; Reed, Gay; Wiepert, Mathieu; Hart, Steven
2017-08-22
Individualized medicine enables better diagnoses and treatment decisions for patients and promotes research in understanding the molecular underpinnings of disease. Linking individual patient's genomic and molecular information with their clinical phenotypes is crucial to these efforts. To address this need, the Center for Individualized Medicine at Mayo Clinic has implemented a genomic data warehouse and a workflow management system to bring data from institutional electronic health records and genomic sequencing data from both clinical and research bioinformatics sources into the warehouse. The system is the foundation for Mayo Clinic to build a suite of tools and interfaces to support various clinical and research use cases. The genomic data warehouse is positioned to play a key role in enhancing the research capabilities and advancing individualized patient care at Mayo Clinic.
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Neuropsychological and psychological interventions for people with newly diagnosed epilepsy.
Jackson, Cerian F; Makin, Selina M; Baker, Gus A
2015-07-22
population. This study was rated as low quality. One study assessed a specialist nurse intervention in an adult population. This study was rating as very low quality.We rated one study as having unclear risk of bias and one study as having high risk of bias.The CBI study indicated that this intervention could significantly reduce depressive symptoms in people with subthreshold depressive disorder. However, the study assessing the effectiveness of a nurse intervention found no significant benefit for depressive symptoms,but did find that in individuals with the least knowledge of epilepsy, a nurse intervention could increase their knowledge of epilepsy scores. Meta-analysis was not possible as we identified only two studies and they utilised different interventions and outcome measures.Previous research has highlighted the impact of psychological and neuropsychological difficulties experienced by people with epilepsy and the negative effect this has on their quality of life. The main finding of this review is that there is a paucity of research assessing possible neuropsychological and psychological interventions for adults with newly diagnosed epilepsy.
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Beard, Renee L.; Fetterman, David J.; Wu, Bei; Bryant, Lucinda
2009-01-01
Purpose: Most individuals with Alzheimer's are cared for in their homes by unpaid family members. Research on caregiving focuses disproportionally on costs of care, service utilization, and negative psychosocial outcomes. Few narrative accounts of Alzheimer's exist; those that do suffer similar pejorative framings and narrow foci. No studies that…
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From experience: applying the risk diagnosing methodology
Keizer, Jimme A.; Halman, Johannes I.M.; Song, Michael
2002-01-01
No risk, no reward. Companies must take risks to launch new products speedily and successfully. The ability to diagnose and manage risks is increasingly considered of vital importance in high-risk innovation. This article presents the Risk Diagnosing Methodology (RDM), which aims to identify and
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From experience : applying the risk diagnosing methodology
Keizer, J.A.; Halman, J.I.M.; Song, X.M.
2002-01-01
No risk, no reward. Companies must take risks to launch new products speedily and successfully. The ability to diagnose and manage risks is increasingly considered of vital importance in high-risk innovation. This article presents the Risk Diagnosing Methodology (RDM), which aims to identify and
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Challenges in diagnosing tuberculosis in children
DEFF Research Database (Denmark)
Rahman, Nadia; Pedersen, Karin Kæreby; Rosenfeldt, Vibeke
2012-01-01
Clinical investigations of childhood tuberculosis (TB) are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. We investigated the challenges in diagnosing TB in children in a low-incidence country.......Clinical investigations of childhood tuberculosis (TB) are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. We investigated the challenges in diagnosing TB in children in a low-incidence country....
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Immunological methods for diagnosing neurocysticercosis
Energy Technology Data Exchange (ETDEWEB)
Kuhn, R.E.; Estrada, J.J.; Grogl, M.
1989-01-31
A method is described for diagnosing active human neurocysticercosis by detecting the presence of at least one Taenia solium larval antigen in cerebrospinal fluid, which comprises: contacting cerebrospinal fluid from a human to be diagnosed with a solid support, wherein the support binds with a Taenia solium larval antigen if present, contacting the support with a first antibody, wherein the first antibody binds with a larval Taenia solium antigen if present in the cerebrospinal fluid, contacting the solid support with a detectable second antibody which will bind with the first antibody, and detecting the second antibody bound to the support.
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Cheryl A. Smith
2008-01-01
Diagnosing Christmas tree problems can be a challenge, requiring a basic knowledge of plant culture and physiology, the effect of environmental influences on plant health, and the ability to identify the possible causes of plant problems. Developing a solution or remedy to the problem depends on a proper diagnosis, a process that requires recognition of a problem and...
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Directory of Open Access Journals (Sweden)
Kertesz Stefan G
2006-09-01
Full Text Available Abstract Background Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Results Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996–1998 were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e.g. depression and anxiety-related disorders (e.g. post-traumatic stress disorder. Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32% and anxiety-related disorders (-20% (p = 0.12. Conclusion Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population.
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Silbermann, Katrin; Schneider, Grit; Grassmann, Ralph
2008-11-01
The human T-cell leukemia virus type 1 (HTLV-1) Tax oncoprotein transforms human lymphocytes and is critical for the pathogenesis of HTLV-1-induced adult T-cell leukaemia. In HTLV-transformed cells, Tax upregulates interleukin (IL)-13, a cytokine with proliferative and anti-apoptotic functions that is linked to leukaemogenesis. Tax-stimulated IL-13 is thought to result in autocrine stimulation of HTLV-infected cells and thus may be relevant to their growth. The causal transactivation of the IL-13 promoter by Tax is predominantly dependent on a nuclear factor of activated T cells (NFAT)-binding P element. Here, it was shown that the isolated IL-13 Tax-responsive element (IL13TaxRE) was sufficient to mediate IL-13 transactivation by Tax and NFAT1. However, cyclosporin A, a specific NFAT inhibitor, revealed that Tax transactivation of IL13TaxRE or wild-type IL-13 promoter was independent of NFAT and that NFAT did not contribute to IL-13 upregulation in HTLV-transformed cells. By contrast, Tax stimulation was repressible by an efficient nuclear factor (NF)-kappaB inhibitor (IkBaDN), indicating the requirement for NF-kappaB. The capacity of NF-kappaB to stimulate IL13TaxRE was demonstrated by a strong response to NF-kappaB in reporter assays and by direct binding of NF-kappaB to IL13TaxRE. Thus, IL13TaxRE in the IL-13 promoter represents a dually active promoter element responsive to NF-kappaB and NFAT. Together, these results indicate that Tax causes IL-13 upregulation in HTLV-1-infected cells via NF-kappaB.
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Normal urinary albumin excretion in recently diagnosed type 1 diabetic patients
DEFF Research Database (Denmark)
Lind, B; Jensen, T; Feldt-Rasmussen, B
1989-01-01
of diabetes. Urinary albumin excretion (median and 95% confidence interval) was similar in the diabetic patients and normal control subjects (8 (6-11) vs 8 (6-11) mg 24-h-1, NS). Four diabetic patients had urinary albumin excretion in the microalbuminuric range of 30-300 mg 24-h-1. There was no significant...... difference between the two groups in urinary excretion of retinol binding protein. The distribution among the individuals of both urinary proteins was positively skewed and similar in the two groups. In conclusion, no significant differences in the urinary excretion of albumin and retinol binding protein...... were found between recently diagnosed Type 1 diabetic patients and normal subjects....
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Kronenberg, Linda M.; Verkerk-Tamminga, Roeliene; Goossens, Peter J. J.; van den Brink, Wim; van Achterberg, Theo
2015-01-01
The process of personal recovery in people diagnosed with substance use disorder and comorbid attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) was mapped. Four general themes representing four consecutive stages in the recovery process were identified in both client
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Marcos, G; Santabárbara, J; Lopez-Anton, R; De-la-Cámara, C; Gracia-García, P; Lobo, E; Pírez, G; Menchón, J M; Palomo, T; Stephan, B C M; Brayne, C; Lobo, A
2016-05-01
In a background of revision of criteria for states of increased risk for progression to dementia, we compare the conversion rate to dementia and Alzheimer's disease (AD) of mild cognitive impairment (MCI) as diagnosed using DSM-5 (DSM-5-MCI) and Petersen's (P-MCI) criteria. A population representative cohort of 4057 dementia-free individuals 55+ years of age was followed up at 2.5 and 4.5 years in Zaragoza, Spain (ZARADEMP). Using the Geriatric Mental State- AGECAT for assessment, research psychiatrists diagnosed DSM-5-MCI and P-MCI following operationalized criteria. 'Conversion rate' (CR), 'annual conversion rate' (ACR), and incidence rate (IR) were calculated along with incidence rate ratio (IRR) to compare the performance of the intermediate cognitive definitions. At 4.5-year follow-up, in individuals aged 65+ years, ACRs for non-cases, P-MCI, and DSM-5-MCI were 0.8, 1.9 and 3.4, respectively, for global dementia. The IRRs were 2.9 and 5.3 for P-MCI and DSM5-MCI, respectively, being the non-cases the reference category. The corresponding values were slightly lower for AD. Conversion rate to dementia and AD was higher using DSM-5-MCI criteria than using Petersen's criteria. However, prediction of the construct still has some way to go, as most MCI individuals did not convert at 4.5-year follow-up. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Hall, Peter A; Fong, Geoffrey T; Cheng, Alice Y
2012-12-01
The primary objective of the current study was to examine the extent to which domain-specific time perspective predicts weight management behaviors (dietary behavior and physical activity) among those newly diagnosed with Type 2 diabetes. A secondary objective was to test potential mediators of the hypothesized effect (behavioral intention, self-efficacy and control beliefs). A total of 204 adults newly diagnosed (≤6 months) with Type 2 diabetes participated in the study, which included a baseline assessment of domain-general and domain-specific time perspective, as well as strength of intention to perform two weight-management behaviors (dietary choice and physical activity); both weight-management behaviors were assessed again at 6 month follow-up. Hierarchical multiple regression analyses revealed a prospective association between domain-specific time perspective and uptake of weight management behaviors. Individuals with newly diagnosed T2DM possessing a future-oriented time perspective reported making less frequent fatty food choices and greater increases in physical activity over the 6-month follow-up interval. These effects were selectively mediated by intention strength, and not competing social cognitive variables. For both behaviors, the total effects and meditational models were robust to adjustments for demographics, body composition and disease variables. A future-oriented time perspective is prospectively associated with superior uptake of weight management behaviors among those with newly diagnosed Type 2 diabetes. The facilitating effect of future-oriented thinking appears to occur via enhanced strength of intentions to perform weight management behaviors.
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Liability for Diagnosing Malingering.
Weiss, Kenneth J; Van Dell, Landon
2017-09-01
Malingering is a medical diagnosis, but not a psychiatric disorder. The label imputes that an evaluee has intentionally engaged in false behavior or statements. By diagnosing malingering, psychiatrists pass judgment on truthfulness. Evaluees taking exception to the label may claim that the professional has committed defamation of character (libel or slander) when the diagnosis is wrong and costs the claimant money or benefits. Clinicians may counter by claiming immunity or that the diagnosis was made in good faith. This problem has come into focus in military and veterans' contexts, where diagnoses become thresholds for benefits. Through historical and literary examples, case law, and military/veterans' claims of disability and entitlement, the authors examine the potency of the malingering label and the potential liability for professionals and institutions of making this diagnosis. © 2017 American Academy of Psychiatry and the Law.
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Mezei, Mária; Ay, Eva; Koroknai, Anita; Tóth, Renáta; Balázs, Andrea; Bakos, Agnes; Gyori, Zoltán; Bánáti, Ferenc; Marschalkó, Márta; Kárpáti, Sarolta; Minárovits, János
2011-11-01
The aim of our study was to monitor the diversity of HIV-1 strains circulating in Hungary and investigate the prevalence of resistance-associated mutations to reverse transcriptase (RT) and protease (PR) inhibitors in newly diagnosed, drug-naive patients. A total of 30 HIV-1-infected patients without prior antiretroviral treatment diagnosed during the period 2008-2010 were included into this study. Viral subtypes and the presence of RT, PR resistance-associated mutations were established by sequencing. Classification of HIV-1 strains showed that 29 (96.6%) patients were infected with subtype B viruses and one patient (3.3%) with subtype A virus. The prevalence of HIV-1 strains with transmitted drug resistance mutations in newly diagnosed individuals was 16.6% (5/30). This study showed that HIV-1 subtype B is still highly predominant in Hungary and documented a relatively high transmission rate of drug resistance in our country.
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Directory of Open Access Journals (Sweden)
Belén Altuna
2009-08-01
Full Text Available This essay works on the opposition between face and mask, where ‘face’ is understood as that which makes every human being singular, and makes visible her or his unique worth, while ‘mask’ is understood as whatever hides that singularity, and refers to a category, stereotype or cliché. The etymological history that relates face and mask to the concept of person, and the history of modern portrait painting, which alternates representations of face and mask, both lead to a discussion with authors who diagnose a contemporary “defeat of the face” as a result of the crisis of humanism and of ethical individualism, which give meaning and dignity to that face.
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DEFF Research Database (Denmark)
Luk, Adriana; Metawee, Mohammed; Ahn, Eric
2009-01-01
. Patient records were reviewed for preoperative clinical diagnoses and other relevant data, including pretransplant endomyocardial biopsy (EMB) results, information regarding left ventricular assist devices and, finally, evidence of disease recurrence in the grafted heart. RESULTS: A shift...... diagnose patients with diseases such as sarcoidosis, amyloidosis and particular types of myocarditis because these can readily recur in the grafted heart. The risk for recurrence must be known to practitioners and, most importantly, to the patient. We strongly recommend the use of EMB if a nonischemic...
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A model for diagnosing and explaining multiple disorders.
Jamieson, P W
1991-08-01
The ability to diagnose multiple interacting disorders and explain them in a coherent causal framework has only partially been achieved in medical expert systems. This paper proposes a causal model for diagnosing and explaining multiple disorders whose key elements are: physician-directed hypotheses generation, object-oriented knowledge representation, and novel explanation heuristics. The heuristics modify and link the explanations to make the physician aware of diagnostic complexities. A computer program incorporating the model currently is in use for diagnosing peripheral nerve and muscle disorders. The program successfully diagnoses and explains interactions between diseases in terms of underlying pathophysiologic concepts. The model offers a new architecture for medical domains where reasoning from first principles is difficult but explanation of disease interactions is crucial for the system's operation.
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Hastrup, Lene Halling; Kongerslev, Mickey T; Simonsen, Erik
2018-03-05
Earlier studies report that although people with borderline personality disorder (BPD) experience symptom reduction in the long term, they continue to have difficulties in work recovery. This nationwide 9-year register-based study (N = 67,075) investigated the long-term labor-market attachment of all individuals diagnosed with BPD during first admission to Danish mental health services in comparison with other psychiatric disorders. Controlling for baseline characteristics and co-occurring secondary psychiatric diagnoses, the BPD group had 32% lower odds (OR = 0.68; 95% CI [0.61, 0.76]) of being in work/under education after 9 years. Individuals diagnosed with BPD also showed more impairment in long-term vocational outcome than other personality disorders, and lower labor-market attachment than other psychiatric disorders except for schizophrenia, schizotypal and delusional disorders, and mental and behavioral disorders due to psychoactive substance use. Intervention programs addressing social psychiatric aspects of BPD in terms of work functioning is henceforth an important area for future research.
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Specialized computer system to diagnose critical lined equipment
Yemelyanov, V. A.; Yemelyanova, N. Y.; Morozova, O. A.; Nedelkin, A. A.
2018-05-01
The paper presents data on the problem of diagnosing the lining condition at the iron and steel works. The authors propose and describe the structure of the specialized computer system to diagnose critical lined equipment. The relative results of diagnosing lining condition by the basic system and the proposed specialized computer system are presented. To automate evaluation of lining condition and support in making decisions regarding the operation mode of the lined equipment, the specialized software has been developed.
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Directory of Open Access Journals (Sweden)
Hind A. Beydoun MPH, PhD
2015-06-01
Full Text Available Objective: To examine whether serum concentrations of C-reactive protein (CRP and fibrinogen were associated with total score on a validated 12-item physical functioning scale and whether the magnitude and direction of these associations differed according to sex and physician-diagnosed arthritis. Method: Secondary analyses of cross-sectional data from the Third National Health and Nutrition Examination Survey were conducted using a representative sample of 4,606 older adults, 60 years and older. Results: Linear models suggested that overall physical functioning was strongly and independently associated with CRP (adjusted β = +.68, 95% confidence interval [CI] = [+0.42, +0.94] and fibrinogen (adjusted β = +1.66, 95% CI = [+0.89, +2.42]; these associations were modified by physician-diagnosed arthritis status, with strongest associations observed among individuals diagnosed with rheumatoid arthritis or no arthritis and weakest association observed among those diagnosed with osteoarthritis. Conclusion: CRP and fibrinogen may be associated with poorer physical functioning in older adults, especially among those having rheumatoid arthritis or no arthritis.
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Gordon, Daniel E; Bian, Fuqin; Anderson, Bridget J; Smith, Lou C
2015-01-01
Prompt entry to care after HIV diagnosis benefits the infected individual and reduces the likelihood of further transmission of the virus. The New York State HIV Testing Law of 2010 requires diagnosing providers to refer persons newly diagnosed with HIV to follow-up medical care. This study used routinely collected HIV-related laboratory data from the New York State HIV surveillance system to assess whether the fraction of newly diagnosed cases entering care within 90 days of diagnosis increased after the implementation of the law. Laboratory data on 23,302 newly diagnosed cases showed that entry to care within 90 days rose steadily from 72.0% in 2007 to 85.4% in 2012. The rise was observed across all race/ethnic groups, ages, transmission risk groups, sexes, and regions of residence. Logistic regression analyses of entry to care pre-law and post-law, controlling for demographic characteristics, transmission risk, and geographic area, indicate that percentage of newly diagnosed cases entering care within 90 days grew more rapidly in the post-law period. This is consistent with a positive effect of the law on entry to care.
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Nesvåg, Ragnar; Jönsson, Erik G; Bakken, Inger Johanne; Knudsen, Gun Peggy; Bjella, Thomas D; Reichborn-Kjennerud, Ted; Melle, Ingrid; Andreassen, Ole A
2017-03-14
Utilization of diagnostic information from national patient registries rests on the quality of the registered diagnoses. We aimed to investigate the agreement and consistency of diagnoses of psychotic and bipolar disorders in the Norwegian Patient Registry (NPR) compared to structured interview-based diagnoses given as part of a clinical research project. Diagnostic data from NPR were obtained for the period 01.01.2008-31.12.2013 for all patients who had been included in the Thematically Organized Psychosis (TOP) study between 18.10.2002 and 01.09.2014 with a Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnosis of schizophrenia (n = 537), delusional disorder (n = 48), schizoaffective disorder (n = 118) or bipolar disorder (n = 408). Diagnostic agreement between the primary DSM-IV diagnosis in TOP and the International Classification of Diseases, 10th revision (ICD-10) diagnoses in NPR was evaluated using Cohen's unweighted nominal kappa (κ). Diagnostic consistency was calculated as the proportion of all registered severe mental disorder diagnoses in NPR that were equivalent to the primary diagnosis given in the TOP study. The proportion of patients registered with the equivalent ICD-10 diagnosis as the primary DSM-IV diagnosis given in TOP was 84.2% for the schizophrenia group, 68.8% for the delusional disorder group, 76.3% for the schizoaffective disorder group, and 78.4% for the bipolar disorder group. Diagnostic agreement was good for schizophrenia (κ = 0.74) and bipolar disorder (κ = 0.72), fair for schizoaffective disorder (κ = 0.63), and poor for delusional disorder (κ = 0.39). Among patients with DSM-IV schizophrenia, 4.7% were diagnosed with ICD-10 bipolar disorder, and among patients with DSM-IV bipolar disorder, 2.5% were diagnosed with ICD-10 schizophrenia. Diagnostic consistency was 84.9% for schizophrenia, 59.1% for delusional disorder, 65.9% for schizoaffective disorder, and 91
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The ICD diagnoses of fetishism and sadomasochism.
Reiersøl, Odd; Skeid, Svein
2006-01-01
In this article we discuss psychiatric diagnoses of sexual deviation as they appear in the International Classification of Diseases (ICD-10), the internationally accepted classification and diagnostic system of the World Health Organization (WHO). Namely, we discuss the background of three diagnostic categories: Fetishism (F65.0), Fetishistic Transvestism (F65.1), and Sadomasochism (F65.5). Pertinent background issues regarding the above categories are followed by a critique of the usefulness of diagnosing these phenomena today. Specifically, we argue that Fetishism, Fetishistic Transvestism, and Sadomasochism, also labeled Paraphilia or perversion, should not be considered illnesses. Finally, we present the efforts of an initiative known as ReviseF65, which was established in 1997, to abolish these diagnoses.
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Kim, Se-Kang; Davison, Mark L.
A study was conducted to examine how principal components analysis (PCA) and Profile Analysis via Multidimensional Scaling (PAMS) can be used to diagnose individuals observed score profiles in terms of core profile patterns identified by each method. The standardization sample from the Wechsler Intelligence Scale for Children, Third Edition…
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How Do Health Care Providers Diagnose Turner Syndrome?
... Email Print How do health care providers diagnose Turner syndrome? Health care providers use a combination of physical ... the X chromosomes is partially or completely missing. Turner syndrome also can be diagnosed during pregnancy by testing ...
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Using Field-Particle Correlations to Diagnose the Collisionless Damping of Plasma Turbulence
Howes, Gregory; Klein, Kristropher
2016-10-01
Plasma turbulence occurs ubiquitously throughout the heliosphere, yet our understanding of how turbulence governs energy transport and plasma heating remains incomplete, constituting a grand challenge problem in heliophysics. In weakly collisional heliospheric plasmas, such as the solar corona and solar wind, damping of the turbulent fluctuations occurs due to collisionless interactions between the electromagnetic fields and the individual plasma particles. A particular challenge in diagnosing this energy transfer is that spacecraft measurements are typically limited to a single point in space. Here we present an innovative field-particle correlation technique that can be used with single-point measurements to estimate the energization of the plasma particles due to the damping of the electromagnetic fields, providing vital new information about this how energy transfer is distributed as a function of particle velocity. This technique has the promise to transform our ability to diagnose the kinetic plasma physical mechanisms responsible for not only the damping of turbulence, but also the energy conversion in both collisionless magnetic reconnection and particle acceleration. The work has been supported by NSF CAREER Award AGS-1054061, NSF AGS-1331355, and DOE DE-SC0014599.
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The failure diagnoses of nuclear reactor systems
International Nuclear Information System (INIS)
Sheng Huanxing.
1986-01-01
The earlier period failure diagnoses can raise the safety and efficiency of nuclear reactors. This paper first describes the process abnormality monitoring of core barrel vibration in PWR, inherent noise sources in BWR, sodium boiling in LMFBR and nuclear reactor stability. And then, describes the plant failure diagnoses of primary coolant pumps, loose parts in nuclear reactors, coolant leakage and relief valve location
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Morgan, Jake R; Schackman, Bruce R; Leff, Jared A; Linas, Benjamin P; Walley, Alexander Y
2018-02-01
We investigated prescribing patterns for four opioid use disorder (OUD) medications: 1) injectable naltrexone, 2) oral naltrexone, 3) sublingual or oralmucosal buprenorphine/naloxone, and 4) sublingual buprenorphine as well as transdermal buprenorphine (which is approved for treating pain, but not OUD) in a nationally representative claims-based database (Truven Health MarketScan®) of commercially insured individuals in the United States. We calculated the prevalence of OUD in the database for each year from 2010 to 2014 and the proportion of diagnosed patient months on OUD medication. We compared characteristics of individuals diagnosed with OUD who did and did not receive these medications with bivariate descriptive statistics. Finally, we fit a Cox proportional hazards model of time to discontinuation of therapy as a function of therapy type, controlling for relevant confounders. From 2010 to 2014, the proportion of commercially insured individuals diagnosed with OUD grew by fourfold (0.12% to 0.48%), but the proportion of diagnosed patient-months on medication decreased from 25% in 2010 (0.05% injectable naltrexone, 0.4% oral naltrexone, 23.1% sublingual or oralmucosal buprenorphine/naloxone, 1.5% sublingual buprenorphine, and 0% transdermal buprenorphine) to 16% in 2014 (0.2% injectable naltrexone, 0.4% oral naltrexone, 13.8% sublingual or oralmucosal buprenorphine/naloxone, 1.4% sublingual buprenorphine, and 0.3% transdermal buprenorphine). Individuals who received medication therapy were more likely to be male, younger, and have an additional substance use disorder compared with those diagnosed with OUD who did not receive medication therapy. Those prescribed injectable naltrexone were more often male, younger, and diagnosed with additional substance use disorders compared with those prescribed other medications for opioid use disorder (MOUDs). At 30 days after initiation, 52% for individuals treated with injectable naltrexone, 70% for individuals treated
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Ethical dilemma and moral distress: proposed new NANDA diagnoses.
Kopala, Beverly; Burkhart, Lisa
2005-01-01
To propose two NANDA diagnoses--ethical dilemma and moral distress--and to distinguish between the NANDA diagnosis decisional conflict and the proposed nursing diagnosis of ethical dilemma. Journal articles, books, and focus group research findings. Moral/ethical situations exist in health care. Nurses' experiences of ethical dilemmas and moral distress are extrapolated to the types and categories of ethical dilemmas and moral distress that patients experience and are used as the basis for development of two new nursing diagnoses. The two proposed NANDA diagnoses fill a void in current standardized terminology. It is important that nurses have the ability to diagnose ethical or moral situations in health care. Currently, NANDA does not offer a means to document this important phenomenon. The creation of two sets of nursing diagnoses, ethical dilemma and moral distress, will enable nurses to recognize and track nursing care related to ethical or moral situations.
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Directory of Open Access Journals (Sweden)
Claudia K Suemoto
2017-03-01
Full Text Available Clinicopathological studies are important in determining the brain lesions underlying dementia. Although almost 60% of individuals with dementia live in developing countries, few clinicopathological studies focus on these individuals. We investigated the frequency of neurodegenerative and vascular-related neuropathological lesions in 1,092 Brazilian admixed older adults, their correlation with cognitive and neuropsychiatric symptoms, and the accuracy of dementia subtype diagnosis.In this cross-sectional study, we describe clinical and neuropathological variables related to cognitive impairment in 1,092 participants (mean age = 74 y, 49% male, 69% white, and mean education = 4 y. Cognitive function was investigated using the Clinical Dementia Rating (CDR and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE; neuropsychiatric symptoms were evaluated using the Neuropsychiatric Inventory (NPI. Associations between neuropathological lesions and cognitive impairment were investigated using ordinal logistic regression. We developed a neuropathological comorbidity (NPC score and compared it to CDR, IQCODE, and NPI scores. We also described and compared the frequency of neuropathological diagnosis to clinical diagnosis of dementia subtype. Forty-four percent of the sample met criteria for neuropathological diagnosis. Among these participants, 50% had neuropathological diagnoses of Alzheimer disease (AD, and 35% of vascular dementia (VaD. Neurofibrillary tangles (NFTs, hippocampal sclerosis, lacunar infarcts, hyaline atherosclerosis, siderocalcinosis, and Lewy body disease were independently associated with cognitive impairment. Higher NPC scores were associated with worse scores in the CDR sum of boxes (β = 1.33, 95% CI 1.20-1.46, IQCODE (β = 0.14, 95% CI 0.13-0.16, and NPI (β = 1.74, 95% CI = 1.33-2.16. Compared to neuropathological diagnoses, clinical diagnosis had high sensitivity to AD and high specificity to dementia with
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Nargiso, Jessica E; Kuo, Caroline C; Zlotnick, Caron; Johnson, Jennifer E
2014-01-01
The nature of social support available to incarcerated women is not well-understood, particularly among women at high risk of negative outcomes, including women dually diagnosed with Major Depressive Disorder and a Substance Use Disorder (MDD-SUD). Descriptive statistics and paired-tests were conducted on 60 incarcerated MDD-SUD women receiving in-prison substance use and depression treatments to characterize the women's social networks, including the strength of support, network characteristics, and types of support provided as well as to determine what aspects of social support may be amenable to change during incarceration and post-release. Study results showed that, on average, women perceived they had moderately supportive individuals in their lives, although more than a quarter of the sample could not identify any regular supporters in their network at baseline. During incarceration, women's social networks significantly increased in general supportiveness, and decreased in network size and percentage of substance users in their networks. Participants maintained positive social support gains post-release in most areas while also significantly increasing the size of their support network post-release. Findings suggest that there are aspects of incarcerated MDD-SUD women's social networks that are amenable to change during incarceration and post-release and provide insight into treatment targets for this vulnerable population.
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Association of serum vitamin D3 with newly diagnosed type 2 diabetes mellitus
Directory of Open Access Journals (Sweden)
Taznuva Anwar
2018-03-01
Full Text Available Vitamin D has an important role and supposed to be a risk factor in the development of pathogenesis of type 2 diabetes mellitus by affecting either insulin sensitivity or β-cell function, or both. The present study was conducted to evaluate the relation of serum vitamin D3 and type 2 diabetes mellitus. Total 80 individuals were enrolled in this study. Forty newly diagnosed type 2 diabetic individual were enrolled as cases and 40 healthy glucose tolerant subjects were enrolled as controls. Serum vitamin D3 was measured by chemiluminescence microparticle immunoassay. Fasting and 2 hours plasma glucose level were measured by hexokinase method using the Dimension clinical chemistry system. The mean serum vitamin D3 level was significantly low in type 2 diabetes mellitus than in controls (p= 0,007. The individual with vitamin D3 deficiency showed 3.4 times higher chances to develop type 2 diabetes mellitus compare to the individual with normal vitamin D status. Correlation test showed significant (r= -0.351 negative correlation (p=0.026 between serum vitamin D3 and type 2 diabetes mellitus. It can be concluded that vitamin D3 deficiency is related to type 2 diabetes mellitus.
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Bhaumik, Sabyasachi; Tyrer, Freya; Barrett, Mary; Tin, Nyunt; McGrother, Catherine W; Kiani, Reza
2010-01-01
It is often difficult to determine the triad of impairments and whether autistic features are the consequence of intellectual impairment or autism spectrum disorders in people with intellectual disability (ID). The aim of the current study was to investigate the relationship between carer-reported autistic traits and independent diagnoses of autism spectrum disorders (ASD). Data were collected on carers' subjective report of autistic traits and clinical diagnoses of ASD. Of 1145 adults with ID identified, 220 (19%) individuals had a diagnosis of ASD, and 778 (68%) individuals had at least one autistic trait. Optimal sensitivity and specificity were achieved with two or more autistic traits (sensitivity 63%; specificity 79%) and the positive predictive value increased substantially as the number of autistic traits increased. However, a significant proportion of individuals with ID who did not have a diagnosis of ASD also displayed autistic traits. Our findings suggest that in the absence of other measures, the presence of autistic traits can serve as a useful proxy measure for ASD in research (and/or clinical settings). However, although information on autistic traits may help healthcare practitioners to identify people with possible ASD, it cannot be used alone to make a formal diagnosis. 2010 Elsevier Ltd. All rights reserved.
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Reliability of clinical ICD-10 schizophrenia diagnoses
DEFF Research Database (Denmark)
Jakobsen, Klaus D; Frederiksen, Julie N; Hansen, Thomas
2005-01-01
Concern has been expressed as to the reliability of clinical ICD-10 diagnosis of schizophrenia. This study was designed to assess the diagnostic reliability of the clinical ICD-10 diagnosis of schizophrenia in a random sample of Danish in- and outpatients with a history of psychosis. A sample...... value (87%) of ICD-10 schizophrenia and an overall good agreement between clinical and OPCRIT-derived diagnoses (kappa=0.60). An even higher positive predictive value was obtained when diagnoses were amalgamated into a diagnostic entity of schizophrenia-spectrum disorders (98%). Near perfect agreement...... was seen between OPCRIT-derived ICD-10 and DSM-IV diagnoses (kappa=0.87). Thus, this study demonstrates high reliability of the clinical diagnosis of schizophrenia and even more so of the diagnosis of schizophrenia-spectrum disorder....
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Collective Thomson scattering capabilities to diagnose fusion plasmas
DEFF Research Database (Denmark)
Korsholm, Søren Bang; Bindslev, Henrik; Furtula, Vedran
2010-01-01
Collective Thomson scattering (CTS) is a versatile technique for diagnosing fusion plasmas. In particular, experiments on diagnosing the ion temperature and fast ion velocity distribution have been executed on a number of fusion devices. In this article the main aim is to describe the technique...
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Diseases of the circulatory system among adult people diagnosed with infantile autism as children
DEFF Research Database (Denmark)
Mouridsen, Svend Erik; Rich, Bente; Isager, Torben
2016-01-01
BACKGROUND: Research dealing with adult people with autism spectrum disorders (ASD) noticeably lags behind studies of children and young individuals with ASD. AIMS: The objective of this study was to compare the prevalence and types of diseases of the circulatory system in a clinical sample of 118...... adult people diagnosed with infantile autism (IA) as children with 336 sex and age matched controls from the general population. METHODS AND PROCEDURES: All participants were screened through the nationwide Danish National Hospital Register. The average observation time of both groups was 37.2 years...
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Attention Training in Individuals with Generalized Social Phobia: A Randomized Controlled Trial
Amir, Nader; Beard, Courtney; Taylor, Charles T.; Klumpp, Heide; Elias, Jason; Burns, Michelle; Chen, Xi
2009-01-01
The authors conducted a randomized, double-blind placebo-controlled trial to examine the efficacy of an attention training procedure in reducing symptoms of social anxiety in 44 individuals diagnosed with generalized social phobia (GSP). Attention training comprised a probe detection task in which pictures of faces with either a threatening or…
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Vallipuram, Janaki; Dhalla, Sidika; Bell, Chaim M; Dresser, Linda; Han, Heekyung; Husain, Shahid; Minden, Mark D; Paul, Narinder S; So, Miranda; Steinberg, Marilyn; Vallipuram, Mayuran; Wong, Gary; Morris, Andrew M
2017-04-01
Chest computed tomography (CT) findings of nodules, ground glass opacities, and consolidations are often interpreted as representing invasive fungal infection in individuals with febrile neutropenia. We assessed whether these CT findings were present in asymptomatic individuals with acute myeloid leukemia (AML) at low risk of invasive fungal disease. A retrospective study of consecutive asymptomatic adult patients with newly diagnosed AML over a 2-year period was performed at a tertiary care oncology center. Radiology reports of baseline chest CTs were reviewed. Of 145 CT scans, the majority (88%) had pulmonary abnormalities. Many (70%) had one or both of unspecified opacities (52%) and nodules (49%). Ground glass opacities (18%) and consolidations (12%) occurred less frequently. Radiologists suggested pneumonia as a possible diagnosis in 32% (n = 47) of scans. Chest CT may result in over-diagnosis of invasive fungal disease in individuals with febrile neutropenia if interpreted without correlation to the patients' clinical status.
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2014-07-01
A previous MSMR report found that 42.8% of all incident (first-time) urinary tract infections (UTIs) in males, but only 0.4% of such UTIs in females, were diagnosed as "urethritis, unspecified" (ICD-9: 597.80). This study explored the possibility that many of the diagnoses of urethritis in males represented sexually transmitted infections (STIs), even though ICD-9: 597.80 is explicitly reserved for cases of urethritis that are deemed to not be sexually transmitted. Examined were relationships between diagnoses of urethritis, diagnoses of STIs, and recurrent diagnoses of UTIs. Male service members who received a diagnosis of "urethritis, unspecified" (ICD-9: 597.80) had an increased risk of a subsequent UTI diagnosis, especially of "urethritis, unspecified," compared to all male service members. Most service members who were diagnosed with "urethritis, unspecified" had no documented diagnoses of an STI in their Military Health System health records; however, recurrent UTIs were more common among service members who did have documented STIs. The most commonly diagnosed STIs in this study were "other non-gonococcal urethritis" (which includes that caused by Chlamydia trachomatis) and gonorrhea.
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Diagnosed hypertension in Canada: incidence, prevalence and associated mortality
Robitaille, Cynthia; Dai, Sulan; Waters, Chris; Loukine, Lidia; Bancej, Christina; Quach, Susan; Ellison, Joellyn; Campbell, Norman; Tu, Karen; Reimer, Kim; Walker, Robin; Smith, Mark; Blais, Claudia; Quan, Hude
2012-01-01
Background: Hypertension is a leading risk factor for cardiovascular diseases. Our objectives were to examine the prevalence and incidence of diagnosed hypertension in Canada and compare mortality among people with and without diagnosed hypertension. Methods: We obtained data from linked health administrative databases from each province and territory for adults aged 20 years and older. We used a validated case definition to identify people with hypertension diagnosed between 1998/99 and 2007/08. We excluded pregnant women from the analysis. Results: This retrospective population-based study included more than 26 million people. In 2007/08, about 6 million adults (23.0%) were living with diagnosed hypertension and about 418 000 had a new diagnosis. The age-standardized prevalence increased significantly from 12.5% in 1998/99 to 19.6% in 2007/08, and the incidence decreased from 2.7 to 2.4 per 100. Among people aged 60 years and older, the prevalence was higher among women than among men, as was the incidence among people aged 75 years and older. The prevalence and incidence were highest in the Atlantic region. For all age groups, all-cause mortality was higher among adults with diagnosed hypertension than among those without diagnosed hypertension. Interpretation: The overall prevalence of diagnosed hypertension in Canada from 1998 to 2008 was high and increasing, whereas the incidence declined during the same period. These findings highlight the need to continue monitoring the effectiveness of efforts for managing hypertension and to enhance public health programs aimed at preventing hypertension. PMID:22105752
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Carmeli, Eli; Klein, Neomy; Sohn, Mordechai
2007-01-01
Attention-deficit/hyperactivity disorder (ADHD) is currently defined as a cognitive/behavioral developmental disorder where all clinical criteria are behavioral. The purpose of this study was to demonstrate a correlation between social skills and ADHD among adolescents with intellectual disabilities (ID). The study concerns the specific cognitive and adaptive skills of adolescents dually diagnosed with mild intellectual disabilities and comorbid pathology as ADHD. Three age-and IQ-match groups (males, n = 12 in each group) were investigated. Group I--composed of adolescent diagnosed with mild ID, group II--adolescents diagnosed with ADHD, and group III--adolescents diagnosed with ID and ADHD. The instruments used in the study were Wechsler Intelligence Scale for Children (WISC, according to the chronological age of the subjects) and the short version of the Developmental Behavior Checklist (DBC). Results confirm that comorbidity is a factor differentiating. ADHD strongly increased the impairment of social skills, while behavioral disorders were less damaging in ID performance. The WISC and DBC instruments should be used with confidence in clinical and service settings, to allow a better assessment of co-occurrence morbidity in adolescents with ID. The interactions between intellectual disability and psychopathology behavior highlight the need to plan a more accurate diagnosis and appropriate rehabilitative intervention program, essential for improving the quality of life of the ID population.
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... breakdown of blood cells, and the liver usually "recycles" it back into the body). Although mild jaundice ... brain). However, PVL can happen without any previous history of bleeding. How is it diagnosed? Often no ...
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Psychosocial covariates of physical activity in recently diagnosed Type 2 diabetes patients
Directory of Open Access Journals (Sweden)
Rajesh Nair
2013-01-01
Full Text Available Background Regular physical activity can be effective not only in preventing diabetes and managing its complications but also be effective in minimizing the risk of developing other chronic diseases among diabetics. The overall aim of study was to determine probable causes of change in physical activity so as to generate evidences for future interventions and to identify psychosocial covariates of self reported physical activity in recently diagnosed Type 2 diabetes cases. Methods Participantsn=478(239interventionarmand239controlarmof an observational cohort were randomized into the ADDITION Plus trial and were recruited from 36 practices in East Anglia region. Participants were people recently diagnosed with diabetes (screen detected and clinically diagnosed within the preceding 3 years were individually randomized and were between the age group of 40-69 years, (mean age 59.2 years. The self reported data regarding physical activity was measured at baseline and one year were used. Demographic and psychosocial (treatment control, consequences, anxiety covariates were assessed at the baseline. Linear univariate and multivariable linear regression analysis was used to quantify the associations between demographic and psychosocial correlates. Results: With regard to the psychosocial correlates(except for participants’ perceptions about the consequences of diabetes, no significant associations with physical activity were found. Treatment control and anxiety failed to predict physical activity. Conclusion The result suggests to further investigate the change in physical activity by including other variables related to demography, other psycho-social and environment influences. Based on the available literature, it is suggested that other factors were found consistently associated with physical activity such as self efficacy, attitude, sensation seeking, family-friend social support, goal orientation, motivation could be studied.
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Ropponen, Annina; Silventoinen, Karri; Hublin, Christer; Svedberg, Pia; Koskenvuo, Markku; Kaprio, Jaakko
2013-06-01
Impaired sleep patterns are known to be associated with many chronic conditions and ultimately they may lead to permanent work incapacity. Less is known about the associations between sleep patterns and cause-specific disability pensions, such as low back diagnoses, or whether familial factors (genetics and family environment) can affect the associations. The objective of this study was to investigate sleep patterns as predictors of disability pension due to low back diagnoses with a 23-year follow-up. A prospective cohort study with comprehensive mailed questionnaires about sleep patterns, e.g., quality and length of sleep in 1975 and 1981. Follow-up from the national disability pension register data until 2004. Not applicable. There were 18,979 individuals (7,722 complete twin pairs) born before 1958. Cox proportional hazards regression was used to calculate hazard ratios (HR) with 95% confidence intervals (95% CI). Disability pension due to low back diagnoses had been granted to 467 individuals during the follow-up. Sleeping moderately well (HR 1.25; 95% CI 1.02, 1.53), or fairly poorly/poorly (HR 2.05; 95% CI 1.53, 2.73) at baseline predicted a significantly higher risk for disability pension. Stable patterns of sleeping either fairly well (HR 1.29; 95% CI 1.01, 1.64), or stably fairly poorly/poorly (HR 2.29; 95% CI 1.49, 3.52) between 1975 and 1981 were associated with a higher risk as compared to a stable pattern of sleeping well. Furthermore, a decrease in quality of sleep from 1975 to 1981 was associated (HR 1.34; 95% CI 1.03, 1.76) with an increased risk of disability pension. Sleep quality and changes in sleep quality appear to be early predictors for disability pension due to low back diagnoses independently from other confounding factors.
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Costing adult Attention-Deficit/Hyperactivity Disorder: Impact on the individual and society
DEFF Research Database (Denmark)
Daley, David; Højbjerg Jacobsen, Rasmus; Lange, Anne-Mette
The study presented in this book estimates the private and social costs of ADHD. The key focus of this book is to study the costs related to individuals with ADHD who have not been diagnosed and who have not received treatment. In this respect, the study makes a unique contribution to scientific ...
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DEFF Research Database (Denmark)
Mertz, Birgitte Goldschmidt; Dunn-Henriksen, Anne Katrine; Kroman, Niels
2017-01-01
AIM: Our aim was to determine the feasibility and effectiveness of an individual, nurse-navigator intervention for relieving distress, anxiety, depression and health-related quality of life in women who have been treated for breast cancer (BC) and are experiencing moderate-to-severe psychological...... and the secondary outcomes were anxiety, depression, health-related quality of life and feasibility of the intervention. RESULTS: Women in the intervention group reported significantly greater satisfaction with treatment and rehabilitation and lower levels of distress (mean 2.7 vs. 5.1, panxiety (mean 5.1 vs...... no significant effects were observed after 6 months, we did find statistically significant effects on distress, anxiety and depression 12 months after diagnosis. Our results will assist in developing rehabilitation to the most vulnerable patients....
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Shen, Yinzhong; Wang, Jiangrong; Wang, Zhenyan; Shen, Jiayin; Tangkai Qi; Song, Wei; Tang, Yang; Liu, Li; Zhang, Renfang; Zeng, Yi; Lu, Hongzhou
2015-04-01
We conducted a cross-sectional study to determine the prevalence and risk factors of leukopenia and thrombocytopenia among Chinese adults with newly diagnosed HIV/AIDS. One thousand nine hundred and forty-eight newly diagnosed HIV-infected patients were enrolled between 2009 and 2010. Serum samples obtained from each individual were collected for complete blood count. Factors associated with the presence of leukopenia and thrombocytopenia were analyzed by multiple logistic regression. The overall prevalence of leukopenia and of thrombocytopenia was 33.2% and 15.6%, respectively. The prevalence of leukopenia was higher among females than among males (39.4% versus 31.2%). The prevalence of leukopenia increased with decreasing CD4 count (8.2%, 26.5%, 33.4%, and 41.5% among patients with CD4 count of ≥ 350, 200-349, 50-199, and risk of leukopenia, and that lower CD4 count, and HIV transmission by blood were significantly associated with an increased risk of thrombocytopenia. The study reflects that leukopenia and thrombocytopenia are common among Chinese adults with newly diagnosed HIV/AIDS; and lower CD4 count is associated with an increased risk of both leukopenia and thrombocytopenia. We propose that a routine assessment of these parameters is necessary for timely and adequate clinical management.
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Nursing diagnoses in patients with chronic venous ulcer: observational study
Directory of Open Access Journals (Sweden)
Glycia de Almeida Nogueira
2015-06-01
Full Text Available This study aimed to analyze nursing diagnoses in people with chronic venous ulcer. An observational, descriptive, quantitative research conducted in an ambulatory specialized in wound treatment, with a non-probabilistic sample of 20 patients. Data collection was performed in an institutional form denominated Assessment Protocol for Clients with Tissue Lesions. Diagnoses were established by consensus among four researchers with experience in nursing diagnoses and wound treatments. From data analysis, 16 diagnoses were identified, with 100% of participants presenting: Impaired tissue integrity, Ineffective peripheral tissue perfusion, Risk of infection, Impaired physical mobility and Ineffective health self-control. These diagnoses are found in Safety/Protection, Activity/Rest and Health promotion domains, which from the clinical practice stand point should be priority focuses in nursing intervention and assessment.
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International Nuclear Information System (INIS)
Kondo, Naoko; Kitagawa, Yoshimi; Satake, Tatsunari; Mayumi, Toshihiko; Kohno, Hiroshi
2007-01-01
Since computed tomography (CT) has made acute appendicitis increasingly easy to diagnose correctly, intravenous contrast-enhanced CT (IV-CT) is increasingly used for this diagnosis. The purpose of this study is to clarify an indication of IV-CT and to eliminate unnecessary IV-CT. We studied whether IV-CT is necessary in all patients suspected of acute appendicitis, given the interval between onset and clinical diagnosis. IV-CT was performed in patient who had right lower quadrant abdominal pain or who had no pain but physical findings at right lower quadrant abdomen. We reviewed detailed medical records of 171 consecutive patients who underwent IV-CT followed by appendectomy within 24 hr. We compared Blumberg's sign, muscle guarding, body temperature, white blood cell count, and C reaction protein, dividing patients into 3 groups-half a day, in which the interval between onset and initial diagnosis was shorter than half a day; 1-day, in which the interval was longer than half a day but shorter than 1 day; and multiple-day, in which the interval exceeded 1 day. We also analyzed IV-CT findings for the abnormal appendix and the number of positive individual CT findings including abnormal appendix, calcified appendicolith, ascites, cecal wall thickening, and dilated intestines. Muscle guarding was significantly common in the patients who had appendicitis among 1-day and multiple-day patients. In IV-CT, enlarged appendix was observed more frequently in those with appendicitis in all 3 groups. Positive individual CT findings were detected more often in multiple-day patients who had appendicitis. We found no significant difference among the other items. A patient diagnosed clinically later than half a day after onset and having muscle guarding should be strongly suspected having acute appendicitis, indicating that IV-CT is not needed in such patients. (author)
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How to diagnose cardiac tamponade
van Steijn, JHM; Sleijfer, DT; van der Graaf, WTA; van der Sluis, A; Nieboer, P
Malignant pericardial effusion is a potentially fatal complication of malignancy unless recognised and treated promptly. Patients with this condition are often difficult to diagnose. Physical examination, chest radiography and electrocardiography have poor diagnostic values in identification of
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Ethical considerations in embedding a surgeon in a military or civilian tactical team.
Kaplan, Lewis J; Siegel, Mark D; Eastman, Alexander L; Flynn, Lisa M; Rosenbaum, Stanley H; Cone, David C; Blake, David P; Mulhern, Jonathan
2012-12-01
Tactical emergency medical services (TEMS) bring immediate medical support to the inner perimeter of special weapons and tactics team activations. While initially envisioned as a role for an individual dually trained as a police officer and paramedic, TEMS is increasingly undertaken by physicians and paramedics who are not police officers. This report explores the ethical underpinnings of embedding a surgeon within a military or civilian tactical team with regard to identity, ethically acceptable actions, triage, responsibility set, training, certification, and potential future refinements of the role of the tactical police surgeon.
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Does part-time sick leave help individuals with mental disorders recover lost work capacity?
Andrén, Daniela
2014-06-01
This paper aims to answer the question whether combining sick leave with some hours of work can help employees diagnosed with a mental disorder (MD) increase their probability of returning to work. Given the available data, this paper analyzes the impact of part-time sick leave (PTSL) on the probability of fully recovering lost work capacity for employees diagnosed with an MD. The effects of PTSL on the probability of fully recovering lost work capacity are estimated by a discrete choice one-factor model using data on a nationally representative sample extracted from the register of the National Agency of Social Insurance in Sweden and supplemented with information from questionnaires. All individuals in the sample were 20-64 years old and started a sickness spell of at least 15 days between 1 and 16 February 2001. We selected all employed individuals diagnosed with an MD, with a final sample of 629 individuals. The results show that PTSL is associated with a low likelihood of full recovery, yet the timing of the assignment is important. PTSL's effect is relatively low (0.015) when it is assigned in the beginning of the spell but relatively high (0.387), and statistically significant, when assigned after 60 days of full-time sick leave (FTSL). This suggests efficiency improvements from assigning employees with an MD diagnosis, when possible, to PTSL. The employment gains will be enhanced if employees with an MD diagnosis are encouraged to return to work part-time after 60 days or more of FTSL.
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Effectiveness of Case Management for Homeless Persons: A Systematic Review
de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.
2013-01-01
We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309
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Methods of recruiting adolescents with psychiatric and substance use disorders for a clinical trial.
Jaffee, William B; Bailey, Genie L; Lohman, Michelle; Riggs, Paula; McDonald, Leah; Weiss, Roger D
2009-01-01
The present article reports on recruiting strategies in a 16-week, multi-site trial of osmotic-release methylphenidate combined with cognitive-behavioral therapy in adolescents with co-occurring attention deficit hyperactivity disorder and substance use disorder. A multifaceted recruiting strategy was employed that targeted multiple referral sources, used incentives, involved numerous staff members, emphasized the therapeutic alliance during prescreening, and utilized data to modify strategies based on results. Overall, 303 adolescents were randomized from 1,333 total referrals across 11 participating sites. Overall, existing treatment program sources, including treatment program staff, social services, the juvenile justice system, and mental health clinics provided a majority of referrals for pre-screening and randomization. These results support the feasibility of recruiting dually-diagnosed adolescents utilizing a multifaceted approach involving the entire study team.
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Manne, Sharon; Winkel, Gary; Zaider, Talia; Rubin, Stephen; Hernandez, Enrique; Bergman, Cynthia
2010-01-01
Objective: Little attention has been paid to the role of nonspecific therapy processes in the efficacy of psychological interventions for individuals diagnosed with cancer. The goal of the current study was to examine the three constructs from the generic model of psychotherapy (GMP): therapeutic alliance, therapeutic realizations, and therapeutic…
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How to diagnose acute appendicitis
DEFF Research Database (Denmark)
Mostbeck, Gerhard; Adam, E Jane; Nielsen, Michael Bachmann
2016-01-01
appendicitis (AA). • Primary US for AA diagnosis will decrease ionizing radiation and cost. • Sensitivity of US to diagnose AA is lower than of CT/MRI. • Non-visualization of the appendix should lead to clinical reassessment. • Complementary MRI or CT may be performed if diagnosis remains unclear....... and complementary imaging with MRI/CT if indicated. Accordingly, both ionizing radiation to our patients and cost of pre-therapeutic diagnosis of AA will be low, with low negative appendectomy and perforation rates. Main Messages • Ultrasound (US) should be the first imaging modality for diagnosing acute...... specificity both in the paediatric and adult patient populations. As US sensitivity is limited, and non-diagnostic US examinations with non-visualization of the appendix are more a rule than an exception, diagnostic strategies and algorithms after non-diagnostic US should focus on clinical reassessment...
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Birdi, Gurkiran; Cooke, Richard; Knibb, Rebecca
2016-01-01
Background. Food allergy is related to poorer quality of life (QoL) and mental health of caregivers. Many parents diagnose food allergy in their child without seeking medical care and there is limited research on this group. This study investigated parental QoL and mental health in parents of children with parent-diagnosed food allergy (PA), medically diagnosed food allergy (MA), and a control group with no allergy (NA). Methods. One hundred and fifty parents from a general population complet...
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Welsh, Justine Wittenauer; Knight, John R; Hou, Sherry Shu-Yeu; Malowney, Monica; Schram, Patricia; Sherritt, Lon; Boyd, J Wesley
2017-06-01
Adolescents with substance use disorders are more likely to have a current psychiatric disorder. However, when compared with the adult literature, there is relatively limited information regarding the specific co-occurrence of certain mental health diagnoses and substance use disorders in adolescents. The objectives of this study were to build on the previous literature regarding mental health diagnoses and different types of substance use disorders in adolescents, as well as explore the differences, if any, between groupings of mental health diagnosis and type of substance used. Data were extracted from the clinical records of 483 individuals aged 11-24 years referred for an evaluation at the Adolescent Substance Abuse Program at Boston Children's Hospital. According to DSM-IV-Text Revision criteria, individuals received diagnoses of substance abuse or dependence and any additional psychiatric disorders. Problematic use was included within the sample for greater power analysis. A multivariable logistic regression model estimated the association between psychiatric diagnosis and substance use while adjusting for covariates including age and gender. Multiple significant associations were found, including having any anxiety-related diagnosis and opioid use (odds ratio [OR] = 2.23, p < .001), generalized anxiety disorder and opioids (OR = 3.42, p = .008), cocaine and post-traumatic stress disorder (OR = 3.61, p = .01), and marijuana and externalizing behavior disorders (OR = 2.10, p = .024). Our study found multiple significant associations between specific substances and certain co-occurring psychiatric disorders. The use of office screening systems to efficiently identify these youths should be a part of routine medical and psychiatric care. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
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How Are Learning Disabilities Diagnosed?
... Research Information Research Goals Activities and Advances Scientific Articles Find a Study Resources and Publications For Patients and Consumers For Researchers and Health Care Providers Home Health A to Z List Learning Disabilities Condition Information How is it diagnosed? Share ...
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Follow-up of prenatally diagnosed unilateral hydronephrosis
DEFF Research Database (Denmark)
Thorup, Jørgen Mogens; Lenz, K; Rabol, A
1996-01-01
Based on previous experience with prenatally diagnosed unilateral hydronephrosis, we found that the primary indications for surgical intervention should be symptoms or functional impairment of the hydronephrotic kidney. Nonoperative management of neonates without symptoms and with normal function...... of the affected kidney was proposed. However, the strategy of treatment after prenatally diagnosed hydronephrosis is still controversial. We studied 28 consecutive children with suspected unilateral pelviureteral junction obstruction and a normal contralateral kidney. The overall follow-up period varied between 2...
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Child Development: New Diagnoses for the NANDA International.
Souza, Juliana Martins de; Cruz, Diná de Almeida Lopes Monteiro da; Veríssimo, Maria De La Ó Ramallo
2018-04-01
The paper proposes new diagnoses on child development (CD) for NANDA International. The study followed the recommended steps of Developmental Processes for NANDA International Nursing Diagnoses. It was a secondary analysis study on the findings of a concept analysis study on CD. A proposal of labels and components of three diagnoses: "Delayed child development," "Risk for delayed child development," and "Readiness for enhanced child development." The proposed diagnoses represent all the complexity of CD. The proposed diagnoses can support nurses in the development of a comprehensive care plan on the health of children. OBJETIVO: propor novos diagnósticos de enfermagem para a NANDA-International que abordem o desenvolvimento infantil. MÉTODO: Este estudo seguiu as etapas recomendadas para o desenvolvimento de diagnósticos de enfermagem da NANDA-International. Foi realizado a partir dos resultados da análise de conceito do termo desenvolvimento infantil. Propostos os títulos e os componentes de três diagnósticos: "Atraso no desenvolvimento infantil," "Risco de atraso no desenvolvimento infantil," e "Disposição para desenvolvimento infantil melhorado." CONCLUSÕES: Os diagnósticos propostos contemplam toda a complexidade do desenvolvimento infantil. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Os novos diagnósticos podem subsidiar o enfermeiro na elaboração de um plano de cuidados integrais à saúde da criança. © 2016 NANDA International, Inc.
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Common diagnoses and treatments in professional voice users.
Franco, Ramon A; Andrus, Jennifer G
2007-10-01
Common problems among all patients seen by the laryngologist are also common among professional voice users. These include laryngopharyngeal reflux, muscle tension dysphonia, fibrovascular vocal fold lesions (eg, nodules and polyps), cysts, vocal fold scarring, changes in vocal fold mobility, and age-related changes. Microvascular lesions and their associated sequelae of vocal fold hemorrhage and laryngitis due to voice overuse are more common among professional voice users. Much more common among professional voice users is the negative impact that voice problems have on their ability to work, on their overall sense of well-being, and sometimes on their very sense of self. This article reviews the diagnosis and treatment options for these and other problems among professional voice users, describing the relevant roles of medical treatment, voice therapy, and surgery. The common scenario of multiple concomitant entities contributing to a symptom complex is underscored. Emphasis is placed on gaining insight into the "whole" patient so that individualized management plans can be developed. Videos of select diagnoses accompany this content online.
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Toor, Nicky; Hanley, Terry; Hebron, Judith
2016-01-01
Many young adults diagnosed with autism spectrum conditions (ASC) intend to go to college and/or university, yet research suggests that these individuals find aspects of college and university life challenging. To explore the views of individuals directly affected by these challenges, a systematic review of the existing qualitative literature in…
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Bonnesen, Kasper; Friesgaard, Kristian D; Boetker, Morten T; Nikolajsen, Lone
2018-04-05
Triage systems are used in emergency medical services to systematically prioritize prehospital resources according to individual patient conditions. Previous studies have shown cases of preventable deaths in emergency medical services even when triage systems are used, indicating a potential undertriage among some conditions. The aim of this study was to investigate the triage level among patients diagnosed with perforated peptic ulcer (PPU) or peptic ulcer bleeding (PUB). In a three-year period in Central Denmark Region, all patients hospitalized within 24 h after a 1-1-2 emergency call and who subsequently received either a PPU or a PUB (hereinafter combined and referred to as PPU/PUB) or a First Hour Quintet (FHQ: respiratory failure, stroke, trauma, cardiac chest pain, and cardiac arrest) diagnosis were investigated. A modified Poisson regression was used to estimate the relative risk of receiving the highest and lowest prehospital response level. Also, a linear regression analysis was used to estimate the relative risk of 30-day mortality. Of 8658 evaluated patients, 263 were diagnosed with PPU/PUB. After adjusting for relevant confounding variables, patients diagnosed with PPU/PUB were less likely to receive ambulance transportation compared to patients diagnosed with stroke, RR = 1.41 (CI: 1.28-1.56); trauma, RR = 1.28 (CI: 1.15-1.42); cardiac chest pain, RR = 1.47 (CI: 1.33-1.62); and cardiac arrest, RR = 1.44 (CI: 1.31-1.42). Among patients diagnosed with PPU/PUB, 6.5% (CI: 3.3-9.7) did not receive ambulance transportation. The proportion of patients not receiving ambulance transportation was higher among patients diagnosed with PPU/PUB compared to patients diagnosed with an FHQ diagnosis. The 30-day mortality rate among patients diagnosed with PPU/PUB was 7.8% (CI: 4.2-11.1). This was lower than the 30-day mortality rate among patients diagnosed with respiratory failure (P = 0.010), stroke (P = 0.001), and cardiac arrest (P
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Increase in depression diagnoses and prescribed antidepressants among young girls
DEFF Research Database (Denmark)
Skovlund, Charlotte Wessel; Kessing, Lars Vedel; Mørch, Lina Steinrud
2017-01-01
AIMS: To analyse trends in depression diagnoses and antidepressant use according to age and gender. METHODS: Nationwide cohort study including all women and men of 10-49 years living in Denmark during 2000-2013. The Psychiatric Registry and Prescription Registry provided data on depression...... diagnoses and antidepressant medication, respectively. Incidence rates as well as 1-year prevalence rates were calculated. RESULTS: The incidence and 1-year prevalence rates of depression diagnoses increased during 2000-2013. The women/men rates were 2.0 for both 1-year prevalence of depressions diagnoses...... and antidepressant use. For adolescent girls, the absolute increase was 3 per 1000 for depression diagnoses and 8 per 1000 for first use of antidepressants, compared to boys who had an increase of 1.1 and 3 per 1000, respectively. Before puberty, boys and girls had almost the same incidence rates of both depression...
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Jacob, Louis; Kalder, Matthias; Kostev, Karel
2017-10-01
To analyze the incidence of depression and anxiety among women newly diagnosed with breast or genital organ cancer (BC or GOC) in Germany. A total of 29 366 women initially diagnosed with BC or GOC between 2005 and 2014 were available for analysis. The main outcome measure was the incidence of depression and anxiety among women newly diagnosed with BC or GOC within 5 years after the first cancer diagnosis in German gynecologist practices. Demographic and clinical data included age, type of cancer, and presence of metastases at diagnosis. The incidence rate of depression and anxiety per 100 person-years was calculated. We performed a multivariate regression model to analyze the association between depression and the variables of interest. In total, 7994 women were diagnosed with depression/anxiety (81.3% had BC and 18.7% had GOC). The incidence of depression and anxiety was 8.8 per 100 person-years in women with BC. In individuals with GOC, the incidence of depression/anxiety was 5.9 per 100 person-years. Breast cancer was associated with a 1.41-fold increase in the risk of developing depression or anxiety as compared with GOC. Patients with metastases also had a higher risk of being depressed and anxious than others (odds ratio = 1.40). Finally, women in the age groups of 41 to 50, 51 to 60, and 61 to 70 years were at a higher risk of depression/anxiety than women in the age group of 71 to 80 years (odds ratios equal to 1.50, 1.38, and 1.22). Women diagnosed with BC were at a higher risk of developing depression or anxiety than women with GOC. Copyright © 2016 John Wiley & Sons, Ltd.
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Pharmaco-EEG: A Study of Individualized Medicine in Clinical Practice.
Swatzyna, Ronald J; Kozlowski, Gerald P; Tarnow, Jay D
2015-07-01
Pharmaco-electroencephalography (Pharmaco-EEG) studies using clinical EEG and quantitative EEG (qEEG) technologies have existed for more than 4 decades. This is a promising area that could improve psychotropic intervention using neurological data. One of the objectives in our clinical practice has been to collect EEG and quantitative EEG (qEEG) data. In the past 5 years, we have identified a subset of refractory cases (n = 386) found to contain commonalities of a small number of electrophysiological features in the following diagnostic categories: mood, anxiety, autistic spectrum, and attention deficit disorders, Four abnormalities were noted in the majority of medication failure cases and these abnormalities did not appear to significantly align with their diagnoses. Those were the following: encephalopathy, focal slowing, beta spindles, and transient discharges. To analyze the relationship noted, they were tested for association with the assigned diagnoses. Fisher's exact test and binary logistics regression found very little (6%) association between particular EEG/qEEG abnormalities and diagnoses. Findings from studies of this type suggest that EEG/qEEG provides individualized understanding of pharmacotherapy failures and has the potential to improve medication selection. © EEG and Clinical Neuroscience Society (ECNS) 2014.
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The Sex Ratio of Full and Half Siblings of People Diagnosed With ADHD in Childhood and Adolescence
DEFF Research Database (Denmark)
Mouridsen, Svend Erik Birkebæk; Rich, Bente; Isager, Torben
2014-01-01
Objective:It has been suggested that high levels of prenatal testosterone exposure are implied in the etiology of male preponderance disorders such as autism spectrum disorder and ADHD. Within this scope, we studied the sex ratio (proportion of males) in siblings of individuals diagnosed with ADHD...... in childhood and adolescence. Method: We did a nationwide, register-based cohort study of the sex ratio in siblings of the 16,381 patients in Denmark diagnosed with ADHD at age 17 years and younger and registered in the nationwide Danish Psychiatric Central Register between January 1, 1994 and May 28, 2013....... Results: Among the 33,151 siblings, 17,041 were males and 16,110 females. This yields a sex ratio of 0.514, which is not statistically significant different from the Danish live birth sex ratio of 0.513 during the relevant years (p = .70). Conclusion: These findings provide no support for the hypothesis...
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Psychosocial covariates of physical activity in recently diagnosed Type 2 diabetes patients
Directory of Open Access Journals (Sweden)
Rajesh Nair
2013-03-01
Full Text Available Background Regular physical activity can be effective not only in preventing diabetes and managing its complications but also be effective in minimizing the risk of developing other chronic diseases among diabetics. The overall aim of study was to determine probable causes of change in physical activity so as to generate evidences for future interventions and to identify psychosocial covariates of self reported physical activity in recently diagnosed Type 2 diabetes cases. Methods Participants n=478 (239 intervention arm and 239 control arm of an observational cohort were randomized into the ADDITION Plus trial and were recruited from 36 practices in East Anglia region. Participants were people recently diagnosed with diabetes (screen detected and clinically diagnosed within the preceding 3 years were individually randomized and were between the age group of 40-69 years, (mean age 59.2 years. The self reported data regarding physical activity was measured at baseline and one year were used. Demographic and psychosocial (treatment control, consequences, anxiety covariates were assessed at the baseline. Linear univariate and multivariable linear regression analysis was used to quantify the associations between demographic and psychosocial correlates. Results: With regard to the psychosocial correlates(except for participants’ perceptions about the consequences of diabetes, no significant associations with physical activity were found. Treatment control and anxiety failed to predict physical activity. Conclusion The result suggests to further investigate the change in physical activity by including other variables related to demography, other psycho-social and environment influences. Based on the available literature, it is suggested that other factors were found consistently associated with physical activity such as self efficacy, attitude, sensation seeking, family-friend social support, goal orientation, motivation could be studied.
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Diagnoser som styringshybrider
DEFF Research Database (Denmark)
Bossen, Claus; Danholt, Peter; Ubbesen, Morten Bonde
2016-01-01
- Relaterede Grupper (DRG). DRG er et internationalt udbredt system til at knytte patienter og deres behandlingsomkostninger sammen i faste kategorier med henblik på at måle hospitalers produktivitet. Med afsæt i Science-Technology-Studies (STS)-feltet analyserer artiklen, hvorledes diagnoser overskrider deres......, hvordan DRG-systemet alternativt kan anskues som en samfundsudviklende infrastruktur, idet det forsamler og skaber gensidigt involverende interaktioner imellem politiske, administrative og sundhedsprofessionelle domæner. En sådan indsigt bidrager til en udvidet forståelse af infrastrukturers roller som...
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Decision tree for accurate infection timing in individuals newly diagnosed with HIV-1 infection.
Verhofstede, Chris; Fransen, Katrien; Van Den Heuvel, Annelies; Van Laethem, Kristel; Ruelle, Jean; Vancutsem, Ellen; Stoffels, Karolien; Van den Wijngaert, Sigi; Delforge, Marie-Luce; Vaira, Dolores; Hebberecht, Laura; Schauvliege, Marlies; Mortier, Virginie; Dauwe, Kenny; Callens, Steven
2017-11-29
There is today no gold standard method to accurately define the time passed since infection at HIV diagnosis. Infection timing and incidence measurement is however essential to better monitor the dynamics of local epidemics and the effect of prevention initiatives. Three methods for infection timing were evaluated using 237 serial samples from documented seroconversions and 566 cross sectional samples from newly diagnosed patients: identification of antibodies against the HIV p31 protein in INNO-LIA, SediaTM BED CEIA and SediaTM LAg-Avidity EIA. A multi-assay decision tree for infection timing was developed. Clear differences in recency window between BED CEIA, LAg-Avidity EIA and p31 antibody presence were observed with a switch from recent to long term infection a median of 169.5, 108.0 and 64.5 days after collection of the pre-seroconversion sample respectively. BED showed high reliability for identification of long term infections while LAg-Avidity is highly accurate for identification of recent infections. Using BED as initial assay to identify the long term infections and LAg-Avidity as a confirmatory assay for those classified as recent infection by BED, explores the strengths of both while reduces the workload. The short recency window of p31 antibodies allows to discriminate very early from early infections based on this marker. BED recent infection results not confirmed by LAg-Avidity are considered to reflect a period more distant from the infection time. False recency predictions in this group can be minimized by elimination of patients with a CD4 count of less than 100 cells/mm3 or without no p31 antibodies. For 566 cross sectional sample the outcome of the decision tree confirmed the infection timing based on the results of all 3 markers but reduced the overall cost from 13.2 USD to 5.2 USD per sample. A step-wise multi assay decision tree allows accurate timing of the HIV infection at diagnosis at affordable effort and cost and can be an important
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Diagnoses and interventions in podiatry.
Zuijderduin, W.M.; Dekker, J.
1996-01-01
In the present study a quantitative description is given of diagnoses and interventions in podiatry. Data are used from a survey on podiatry practice in The Netherlands. Data have been recorded by 36 podiatrists on 897 patients. Information was gathered on patient characteristics, the medical
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Directory of Open Access Journals (Sweden)
Girouard C
2016-09-01
Full Text Available Catherine Girouard,1–3 Jean-Pierre Grégoire,1–3 Paul Poirier,2,4 Jocelyne Moisan1–3 1Chair on Adherence to Treatments, Université Laval, 2Faculty of Pharmacy, Université Laval, 3Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Center, 4Quebec Heart and Lung Institute-Université Laval, Quebec City, QC, Canada Purpose: β-Blockers (bisoprolol, carvedilol, and metoprolol are the cornerstone of heart failure (HF management. The incidence rate of β-blocker initiation and discontinuation and their associated factors among seniors with a first HF diagnosis were assessed.Methods: A population-based inception cohort study that included all individuals aged ≥65 years with a first HF diagnosis in Quebec was conducted. β-Blockers initiation among 91,131 patients who were not using β-blockers at the time of HF diagnosis and discontinuation among those who initiated a β-blocker after HF diagnosis were assessed. Stepwise Cox regression analyses were used to calculate hazard ratios (HR and to identify factors associated with β-blocker initiation and discontinuation.Results: After HF diagnosis, 32,989 (36.2% individuals initiated a β-blocker. Of these, 15,408 (46.7% discontinued their β-blocker during the follow-up. Individuals more likely to initiate a β-blocker were those diagnosed in a recent calendar year (2009: HR, 2.11; 95% confidence interval [CI], 2.00–2.23 and diagnosed by a cardiologist (HR, 1.38; 95% CI, 1.34–1.42. Individuals less likely to initiate were those aged ≥90 years (HR, 0.65; 95% CI, 0.61–0.68 and those with chronic obstructive pulmonary disease (HR, 0.66; 95% CI, 0.64–0.68. Individuals more likely to discontinue were those with more than nine medical consultations (HR, 1.14; 95% CI, 1.10–1.18 and those with dementia (HR, 1.13; 95% CI, 1.01–1.27. Individuals less likely to discontinue were those diagnosed in a recent calendar year (2009: HR 0.74; 95% CI, 0.65–0.82 and
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Resilience and Associated Factors among Mainland Chinese Women Newly Diagnosed with Breast Cancer.
Wu, Zijing; Liu, Ye; Li, Xuelian; Li, Xiaohan
2016-01-01
Resilience is the individual's ability to bounce back from trauma. It has been studied for some time in the U.S., but few studies in China have addressed this important construct. In mainland China, relatively little is known about the resilience of patients in clinical settings, especially among patients with breast cancer. In this study, we aimed to evaluate the level of resilience and identify predictors of resilience among mainland Chinese women newly diagnosed with breast cancer. A cross-sectional descriptive study was conducted with 213 mainland Chinese women newly diagnosed with breast cancer between November 2014 and June 2015. Participants were assessed with the Connor-Davidson Resilience Scale (CD-RISC), Social Support Rating Scale (SSRS), Medical Coping Modes Questionnaire (MCMQ, including 3 subscales: confrontation, avoidance, and acceptance-resignation), Herth Hope Index (HHI), and demographic and disease-related information. Descriptive statistics, bivariate analyses and multiple stepwise regression were conducted to explore predictors for resilience. The average score for CD-RISC was 60.97, ranging from 37 to 69. Resilience was positively associated with educational level, family income, time span after diagnosis, social support, confrontation, avoidance, and hope. However, resilience was negatively associated with age, body mass index (BMI), and acceptance-resignation. Multiple stepwise regression analysis indicated that hope (β = 0.343, Pconfrontation (β = 0.187, P = 0.001), and age (β = -0.108, P = 0.037) significantly affected resilience and explained 50.1% of the total variance in resilience. Women with newly diagnosed breast cancer from mainland China demonstrated particularly low resilience level, which was predicted by hope educational level, avoidance, confrontation, and age.
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Pitch and Loudness from Tinnitus in Individuals with Noise-induced Hearing Loss
Directory of Open Access Journals (Sweden)
Flores, Leticia Sousa
2015-08-01
Full Text Available Introduction Tinnitus is one of the symptoms that affects individuals suffering from noise induced hearing loss. This condition can be disabling, leading the affected individual to turn away from work. Objective This literature review aims to analyze the possible association between gender and tinnitus pitch and loudness, the degree of hearing loss and the frequencies affected in subjects with noise-induced hearing loss. Methods This contemporary cohort study was conducted through a cross-sectional analysis. The study sample consisted of adults with unilateral or bilateral tinnitus, who had been diagnosed with noise-induced hearing loss. The patients under analysis underwent an otorhinolaryngological evaluation, pure tone audiometry, and acuphenometry. Results The study included 33 subjects with noise-induced hearing loss diagnoses, of which 22 (66.7% were men. Authors observed no statistical difference between gender and loudness/pitch tinnitus and loudness/pitch in subjects with bilateral tinnitus. Authors found an inverse relation between tinnitus loudness with intensity greater hearing threshold and the average of the thresholds and the grade of hearing loss. The tinnitus pitch showed no association with higher frequency of hearing threshold. Conclusion Data analysis shows that, among the individuals evaluated, the greater the hearing loss, the lower the loudness of tinnitus. We did not observe an association between hearing loss and tinnitus pitch.
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FDG-PET for diagnosing prosthetic joint infection: systematic review and metaanalysis
Energy Technology Data Exchange (ETDEWEB)
Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Kwee, Robert M. [University Medical Center Maastricht, Department of Radiology, Maastricht (Netherlands); Alavi, Abass [Hospital of the University of Pennsylvania, Division of Nuclear Medicine, Philadelphia, PA (United States)
2008-11-15
The aim of this study was to systematically review and metaanalyze published data on the diagnostic performance of {sup 18}F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) in detecting prosthetic hip or knee joint infection. A systematic search for relevant studies was performed of the PubMed/MEDLINE and Embase databases. Two reviewers independently assessed the methodological quality of each study. A metaanalysis of the reported sensitivity and specificity of each study was performed. Subgroup analyses were performed if results of individual studies were heterogeneous. The inclusion criteria were met by 11 studies; there was a total sample size of 635 prostheses. Overall, the studies had good methodological quality. Pooled sensitivity and specificity of FDG-PET for the detection of prosthetic hip or knee joint infection were 82.1% (95%CI = 68.0-90.8%) and 86.6% (95%CI = 79.7-91.4%), respectively. Heterogeneity among the results of individual studies was present (I {sup 2} = 68.8%). Diagnostic performance was influenced by type of joint prostheses (hip prostheses vs. knee prostheses) and type of reconstruction method used (filtered back vs. iterative) (p = 0.0164 and p = 0.0235, respectively). In this metaanalysis, overall diagnostic performance of FDG-PET was moderate to high. Caution is warranted, however, because results of individual studies were heterogeneous and could not be fully explored. Future studies should further explore potential causes of heterogeneity and validate the use of FDG-PET for diagnosing prosthetic joint infection. (orig.)
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FDG-PET for diagnosing prosthetic joint infection: systematic review and metaanalysis
International Nuclear Information System (INIS)
Kwee, Thomas C.; Kwee, Robert M.; Alavi, Abass
2008-01-01
The aim of this study was to systematically review and metaanalyze published data on the diagnostic performance of 18 F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) in detecting prosthetic hip or knee joint infection. A systematic search for relevant studies was performed of the PubMed/MEDLINE and Embase databases. Two reviewers independently assessed the methodological quality of each study. A metaanalysis of the reported sensitivity and specificity of each study was performed. Subgroup analyses were performed if results of individual studies were heterogeneous. The inclusion criteria were met by 11 studies; there was a total sample size of 635 prostheses. Overall, the studies had good methodological quality. Pooled sensitivity and specificity of FDG-PET for the detection of prosthetic hip or knee joint infection were 82.1% (95%CI = 68.0-90.8%) and 86.6% (95%CI = 79.7-91.4%), respectively. Heterogeneity among the results of individual studies was present (I 2 = 68.8%). Diagnostic performance was influenced by type of joint prostheses (hip prostheses vs. knee prostheses) and type of reconstruction method used (filtered back vs. iterative) (p = 0.0164 and p = 0.0235, respectively). In this metaanalysis, overall diagnostic performance of FDG-PET was moderate to high. Caution is warranted, however, because results of individual studies were heterogeneous and could not be fully explored. Future studies should further explore potential causes of heterogeneity and validate the use of FDG-PET for diagnosing prosthetic joint infection. (orig.)
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Problems faced by newly diagnosed diabetes mellitus patients at ...
African Journals Online (AJOL)
Diabetes mellitus can be a frightening experience for newly diagnosed patients. The aim of this study was to determine and describe the problems faced by newly diagnosed diabetes mellitus patients at primary healthcare facilities at Mopani district, Limpopo Province. A qualitative, descriptive and contextual research ...
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Considerations in civil commitment of individuals with substance use disorders.
Cavaiola, Alan A; Dolan, David
2016-01-01
Several states currently have enacted laws that allow for civil commitment for individuals diagnosed with severe substance use disorders. Civil commitment or involuntary commitment refers to the legal process by which individuals with mental illness are court-ordered into inpatient and/or outpatient treatment programs. Although initially civil commitment laws were intended for individuals with severe mental illness, these statutes have been extended to cover individuals with severe substance use disorders. Much of the recent legislation allowing for civil commitment of individuals with substance use disorders has come about in response to the heroin epidemic and is designed to provide an alternative to the unrelenting progression of opioid use disorders. Civil commitment also provides an opportunity for individuals with opioid use disorders to make informed decisions regarding ongoing or continued treatment. However, civil commitment also raises concerns regarding the potential violation of 14th Amendment rights, specifically pertaining to abuses of deprivation of liberty or freedom, which are guaranteed under the 14th Amendment to the United States Constitution. This commentary examines these issues while supporting the need for effective brief civil commitment legislation in all states.
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Leaf, Justin B.; Dale, Stephanie; Kassardjian, Alyne; Tsuji, Kathleen H.; Taubman, Mitchell; McEachin, John J.; Leaf, Ronald B.; Oppenheim-Leaf, Misty L.
2014-01-01
One of the basic principles of applied behavior analysis is that behavior change is largely due to that behavior being reinforced. Therefore the use of positive reinforcement is a key component of most behavioral programs for individuals diagnosed with autism. In this study we compared four different classes of reinforcers (i.e., food, praise,…
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Yoo, Yongjoon; Park, Hyeon-Ju; Park, Soowon; Cho, Maeng Je; Cho, Seong-Jin; Lee, Ji Yeon; Choi, Soo-Hee; Lee, Jun-Young
2018-01-01
Individuals with posttraumatic stress disorder (PTSD) are more prone to suicidal ideation and behavior. While those who have experienced interpersonal trauma exhibit more suicidality than those who have experienced non-interpersonal trauma, it is unclear how the traumatic effects are related to an individual's personality characteristics. This study examined the association between interpersonal trauma and personality factors with suicidality, and elucidated the moderating role of interpersonal trauma in individuals with PTSD. The study included 6,022 participants from the Korean Epidemiologic Catchment Area Study 2011. The Korean Version of Composite International Diagnostic Interview was used for the survey, including the participants' history of suicidality, the traumas they have experienced, and their PTSD symptoms. The 11-item version of the Big Five Inventory (BFI-11) was used to assess the participants' personality factors. 76 individuals were diagnosed with PTSD, while 810 had been exposed to trauma but were not diagnosed with any DSM-IV mental disorder. Among the individuals with PTSD, those who had experienced interpersonal trauma were more likely to have suicidal ideation than those who had experienced non-interpersonal trauma (p = .020; odds ratio [OR] = 3.643; 95% confidence interval of OR = [1.226, 10.825]). High agreeableness and conscientiousness predicted less suicidality in those exposed to non-interpersonal trauma, while predicting more suicidality in those exposed to interpersonal trauma. Clinicians examining individuals with PTSD should pay closer attention to the trauma that they have experienced, as well as their personality factors, to provide appropriate treatment.
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Décary, Simon; Frémont, Pierre; Pelletier, Bruno; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François
2018-04-01
To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude patellofemoral pain (PFP). Prospective diagnostic study. Orthopedic outpatient clinics, family medicine clinics, and community-dwelling. Consecutive patients (N=279) consulting one of the participating orthopedic surgeons (n=3) or sport medicine physicians (n=2) for any knee complaint. Not applicable. History elements and physical examination tests were obtained by a trained physiotherapist blinded to the reference standard: a composite diagnosis including both physical examination tests and imaging results interpretation performed by an expert physician. Penalized logistic regression (least absolute shrinkage and selection operator) was used to identify history elements and physical examination tests associated with the diagnosis of PFP, and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios with associated 95% confidence intervals (CIs) were calculated. Two hundred seventy-nine participants were evaluated, and 75 had a diagnosis of PFP (26.9%). Different combinations of history elements and physical examination tests including the age of participants, knee pain location, difficulty descending stairs, patellar facet palpation, and passive knee extension range of motion were associated with a diagnosis of PFP and used in clusters to accurately discriminate between individuals with PFP and individuals without PFP. Two diagnostic clusters developed to confirm the presence of PFP yielded a positive likelihood ratio of 8.7 (95% CI, 5.2-14.6) and 3 clusters to exclude PFP yielded a negative likelihood ratio of .12 (95% CI, .06-.27). Diagnostic clusters combining common history elements and physical examination tests that can accurately diagnose or exclude PFP compared to various knee
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Stone's representation theorem in fuzzy topology
Institute of Scientific and Technical Information of China (English)
刘应明; 张德学
2003-01-01
In this paper, a complete solution to the problem of Stone's repesentation theorem in fuzzy topology is given for a class of completely distributive lattices. Precisely, it is proved that if L is a frame such that 0 ∈ L is a prime or 1 ∈ L is a coprime, then the category of distributive lattices is dually equivalent to the category of coherent L-locales and that if L is moreover completely distributive, then the category of distributive lattices is dually equivalent to the category of coherent stratified L-topological spaces.
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Predicting early cognitive decline in newly-diagnosed Parkinson's patients: A practical model.
Hogue, Olivia; Fernandez, Hubert H; Floden, Darlene P
2018-06-19
To create a multivariable model to predict early cognitive decline among de novo patients with Parkinson's disease, using brief, inexpensive assessments that are easily incorporated into clinical flow. Data for 351 drug-naïve patients diagnosed with idiopathic Parkinson's disease were obtained from the Parkinson's Progression Markers Initiative. Baseline demographic, disease history, motor, and non-motor features were considered as candidate predictors. Best subsets selection was used to determine the multivariable baseline symptom profile that most accurately predicted individual cognitive decline within three years. Eleven per cent of the sample experienced cognitive decline. The final logistic regression model predicting decline included five baseline variables: verbal memory retention, right-sided bradykinesia, years of education, subjective report of cognitive impairment, and REM behavior disorder. Model discrimination was good (optimism-adjusted concordance index = .749). The associated nomogram provides a tool to determine individual patient risk of meaningful cognitive change in the early stages of the disease. Through the consideration of easily-implemented or routinely-gathered assessments, we have identified a multidimensional baseline profile and created a convenient, inexpensive tool to predict cognitive decline in the earliest stages of Parkinson's disease. The use of this tool would generate prediction at the individual level, allowing clinicians to tailor medical management for each patient and identify at-risk patients for clinical trials aimed at disease modifying therapies. Copyright © 2018. Published by Elsevier Ltd.
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Directory of Open Access Journals (Sweden)
Tropp Hans
2005-06-01
Full Text Available Abstract Background The tissue origin of low back pain (LBP or referred lower extremity symptoms (LES may be identified in about 70% of cases using advanced imaging, discography and facet or sacroiliac joint blocks. These techniques are invasive and availability varies. A clinical examination is non-invasive and widely available but its validity is questioned. Diagnostic studies usually examine single tests in relation to single reference standards, yet in clinical practice, clinicians use multiple tests and select from a range of possible diagnoses. There is a need for studies that evaluate the diagnostic performance of clinical diagnoses against available reference standards. Methods We compared blinded clinical diagnoses with diagnoses based on available reference standards for known causes of LBP or LES such as discography, facet, sacroiliac or hip joint blocks, epidurals injections, advanced imaging studies or any combination of these tests. A prospective, blinded validity design was employed. Physiotherapists examined consecutive patients with chronic lumbopelvic pain and/or referred LES scheduled to receive the reference standard examinations. When diagnoses were in complete agreement regardless of complexity, "exact" agreement was recorded. When the clinical diagnosis was included within the reference standard diagnoses, "clinical agreement" was recorded. The proportional chance criterion (PCC statistic was used to estimate agreement on multiple diagnostic possibilities because it accounts for the prevalence of individual categories in the sample. The kappa statistic was used to estimate agreement on six pathoanatomic diagnoses. Results In a sample of chronic LBP patients (n = 216 with high levels of disability and distress, 67% received a patho-anatomic diagnosis based on available reference standards, and 10% had more than one tissue origin of pain identified. For 27 diagnostic categories and combinations, chance clinical agreement
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Conflict adaptation in patients diagnosed with schizophrenia.
Abrahamse, Elger; Ruitenberg, Marit; Boddewyn, Sarah; Oreel, Edith; de Schryver, Maarten; Morrens, Manuel; van Dijck, Jean-Philippe
2017-11-01
Cognitive control impairments may contribute strongly to the overall cognitive deficits observed in patients diagnosed with schizophrenia. In the current study we explore a specific cognitive control function referred to as conflict adaptation. Previous studies on conflict adaptation in schizophrenia showed equivocal results, and, moreover, were plagued by confounded research designs. Here we assessed for the first time conflict adaptation in schizophrenia with a design that avoided the major confounds of feature integration and stimulus-response contingency learning. Sixteen patients diagnosed with schizophrenia and sixteen healthy, matched controls performed a vocal Stroop task to determine the congruency sequence effect - a marker of conflict adaptation. A reliable congruency sequence effect was observed for both healthy controls and patients diagnosed with schizophrenia. These findings indicate that schizophrenia is not necessarily accompanied by impaired conflict adaptation. As schizophrenia has been related to abnormal functioning in core conflict adaptation areas such as anterior cingulate and dorsolateral prefrontal cortex, further research is required to better understand the precise impact of such abnormal brain functioning at the behavioral level. Copyright © 2017 Elsevier B.V. All rights reserved.
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Juul, Jakob Søgaard; Andersen, Berit; Laurberg, Søren; Carlsen, Anders Helles; Olesen, Frede; Vedsted, Peter
2018-06-22
To investigate the diagnostic activity in general practice and the cumulative incidence of colorectal cancer (CRC) in individuals invited to the Danish national screening programme for CRC. A historical population-based cohort study. The Danish CRC screening programme and general practice. The 376,198 individuals invited to the Danish CRC screening programme from 1 March to 31 December 2014. The diagnostic activity (consultations and haemoglobin measures) in general practice in the year preceding the screening invitation and the cumulated incidence of CRC in the year following the screening invitation. Screening participants had significantly higher diagnostic activity than non-participants. Individuals with a positive faecal immunochemical test (FIT) had higher diagnostic activity compared to individuals with a negative FIT, and a small increase in the months leading up to the invitation. Individuals with a screen-detected CRC had lower diagnostic activity than individuals with no CRC. In total, 308 (25.3%) of CRCs diagnosed in the invited population were diagnosed outside the screening programme. Non-participants with CRC more often had low socio-economic status, high comorbidity and stage IV CRC than participants with CRC. There was a tendency that participants and those with a positive FIT had a higher diagnostic activity the year before the screening. This was not seen for those with CRC detected through screening. CRC must still be diagnosed in general practice in the invited population and non-participants are of special interest as they have higher risk of late stage CRC. Key Points Current awareness:Individuals with colorectal cancer (CRC) in screening may be symptomatic and CRC may still occur outside screening in the invited population. Most important points:The majority of individuals with CRC in screening cannot be expected to be diagnosed on symptomatic presentation in general practice GPs have to be aware that CRC still occurs outside screening in
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Prevalence of item level negative symptoms in first episode psychosis diagnoses.
LENUS (Irish Health Repository)
Lyne, John
2012-03-01
The relevance of negative symptoms across the diagnostic spectrum of the psychoses remains uncertain. The purpose of this study was to report on prevalence of item and subscale level negative symptoms across the first episode psychosis (FEP) diagnostic spectrum in an epidemiological sample, and to ascertain whether items and subscales were more prevalent in a schizophrenia spectrum diagnoses group compared to an \\'all other psychotic diagnoses\\' group. We measured negative symptoms in 330 patients presenting with FEP using the Scale for Assessment of Negative Symptoms (SANS), and ascertained diagnosis using the Structured Clinical Interview for DSM IV. Prevalence of SANS items and subscales were tabulated across all psychotic diagnoses, and logistic regression analysis determined which items and subscales were predictive of schizophrenia spectrum diagnoses. SANS items were most prevalent in schizophrenia spectrum conditions but frequently presented in other FEP diagnoses, particularly substance induced psychotic disorder and Major Depressive Disorder. Brief psychotic disorder and bipolar disorders had low levels of negative symptoms. SANS items and subscales which significantly predicted schizophrenia spectrum diagnoses, were also frequently present in some of the other psychotic diagnoses. Conclusions: SANS items have high prevalence in FEP, and while commonest in schizophrenia spectrum conditions are not restricted to this diagnostic subgroup.
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Two Cases of True Uterine Artery Aneurysms Diagnosed during Pregnancy
DEFF Research Database (Denmark)
Schlütter, Jacob Mørup; Johansen, Gry; Helmig, Rikke Bek
2016-01-01
We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the fir...... masses, vague bladder symptoms or radiating pelvic pain. The diagnosis is readily made by color Doppler imaging. Elective Caesarean section should be the preferred mode of delivery to avoid rupture of the aneurysm during labor.......We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the first...
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Sharpley, Christopher F; Bitsika, Vicki; Christie, David R H
2014-09-01
Depression in men diagnosed with prostate cancer is associated with several adverse outcomes. However, some data suggest that standard methods of assessing depression in males via the criteria for Major Depressive Disorder (MDD) may omit several extra key symptoms of male depression. Therefore, this study tested the comparative effects of standard MDD-based diagnostic criteria for depression and criteria for 'male depression' in a sample of men diagnosed with prostate cancer. 191 men diagnosed with prostate cancer completed a postal survey questionnaire containing questions about background variables, the Patient Health Questionnaire-9 for depression (PHQ9) and the Gotland Male Depression Scale (GMDS). Comparisons were made of the relative prevalence of depression according to these scales, plus a scale that combined the PHQ9 and GMDS extra items for male depression Although there were significant correlations between total PHQ9 and GMDS scores, over one-third of variance in the GMDS was not accounted for by the PHQ9, and sensitivity of the PHQ9 against the GMDS showed that about 24% of those patients identified as depressed on the GMDS would not be similarly identified on the PHQ9. Different prevalence rates from the two scales suggested that they were assessing different sets of symptoms of depression. A combined PHQ9-GMDS scale of 15 items was used to produce a profile of male depression in these patients. Adequate and reliable assessment of depression in men diagnosed with prostate cancer may require use of additional symptoms to those listed for MDD, and treatment planning and delivery could be more precise and effective using this methodology. Copyright © 2014 John Wiley & Sons, Ltd.
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The Redundancy Effect on Retention and Transfer for Individuals with High Symptoms of ADHD
Brown, Victoria; Lewis, David; Toussaint, Mario
2016-01-01
The multimedia elements of text and audio need to be carefully integrated together to maximize the impact of those elements for learning in a multimedia environment. Redundancy information presented through audio and visual channels can inhibit learning for individuals diagnosed with ADHD, who may experience challenges in the processing of…
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Costing adult Attention-Deficit/Hyperactivity Disorder: Impact on the individual and society
DEFF Research Database (Denmark)
Daley, David; Højbjerg Jacobsen, Rasmus; Lange, Anne-Mette
The study presented in this book estimates the private and social costs of ADHD. The key focus of this book is to study the costs related to individuals with ADHD who have not been diagnosed and who have not received treatment. In this respect, the study makes a unique contribution to scientific...... knowledge by investigating the cost of untreated ADHD. The study investigates the extent to which individuals with undiagnosed ADHD in childhood fare differently compared to otherwise similar individuals without ADHD. A long list of important parameters in an individual's life, e.g. educational attainment......, occupational status, income, family situation, criminal record, health is examined. The results of the study provide not just cost estimates of ADHD; per se, but also create a point of reference which will be highly relevant for the evaluation of any future treatment for ADHD....
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Nursing diagnoses in patients with immune-bullous dermatosis
Directory of Open Access Journals (Sweden)
Euzeli da Silva Brandão
Full Text Available ABSTRACT Objective: identify nursing diagnoses in patients with immune-bullous dermatosis. Method: a quantitative and descriptive research, carried out in three institutions located in Rio de Janeiro and Mato Grosso do Sul, Brazil, using the Client Assessment Protocol in Dermatology during a nursing consultation. Simple descriptive statistics was used for data analysis. Results: 14 subjects participated in the study, nine with a diagnosis of pemphigus vulgaris, pemphigus two and three of bullous pemphigoid. The age ranged between 27 and 82 years, predominantly females (11. 14 nursing diagnoses were discussed and identified from a clinical rationale in all study participants, representing the most common human responses in this sample. The application of the Assessment Protocol in Dermatology facilitated the comprehensive assessment, in addition to providing the identification of diagnostics according to the North American Nursing Diagnosis Association International. Conclusion: the nursing diagnoses presented confirm the necessity of interdisciplinary work during the care for this clientele. For better description of the phenomena related to the client in question, it is suggested the inclusion of two risk factors related in three diagnoses of this taxonomy. It is worth noting the contribution of the findings for the care, education and research in nursing in dermatology.
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McAdams, Mara A; Maynard, Janet W; Baer, Alan N; Köttgen, Anna; Clipp, Sandra; Coresh, Josef; Gelber, Allan C
2011-01-01
gout is often defined by self-report in epidemiologic studies. Yet the validity of self-reported gout is uncertain. We evaluated the reliability and sensitivity of the self-report of physician-diagnosed gout in the Campaign Against Cancer and Heart Disease (CLUE II) and the Atherosclerosis Risk in the Community (ARIC) cohorts. the CLUE II cohort comprises 12,912 individuals who self-reported gout status on either the 2000, 2003, or 2007 questionnaires. We calculated reliability as the percentage of participants reporting having gout on more than 1 questionnaire using Cohen's κ statistic. The ARIC cohort comprises 11,506 individuals who self-reported gout status at visit 4. We considered a hospital discharge diagnosis of gout or use of a gout-specific medication as the standard against which to calculate the sensitivity of self-reported, physician-diagnosed gout. of the 437 CLUE II participants who self-reported physician-diagnosed gout in 2000, and subsequently answered the 2003 questionnaire, 75% reported gout in 2003 (κ = 0.73). Of the 271 participants who reported gout in 2000, 73% again reported gout at the 2007 followup questionnaire (κ = 0.63). In ARIC, 196 participants met the definition for gout prior to visit 4 and self-reported their gout status at visit 4. The sensitivity of a self-report of physician-diagnosed gout was 84%. Accuracy was similar across sex and race subgroups, but differed across hyperuricemia and education strata. these 2 population-based US cohorts suggest that self-report of physician-diagnosed gout has good reliability and sensitivity. Thus, self-report of a physician diagnosis of gout is appropriate for epidemiologic studies.
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DEFF Research Database (Denmark)
Jørgensen, Louise B; Christensen, Marianne B; Gerstoft, Jan
2003-01-01
The aim of this study was to monitor the prevalence of drug resistance mutations in newly diagnosed HIV-1 positive individuals in Denmark. In addition we assessed the prevalence of non-B subtypes based on phylogenetic analysis of the pol gene. Plasma samples from 104 newly diagnosed HIV-1 positive...... patients were obtained in the year 2000. The entire protease gene and 320 amino acids of the reverse transcriptase gene were genotyped. Sequences were obtained from 97 patients. No subjects displayed primary resistance mutations in the protease gene, whereas all carried 1 or more secondary mutations....... Resistance mutations in the RT-gene associated with NRTI-resistance were found in 1 patient, who was infected with zidovudine resistant HIV-1 harbouring the M41L mutation in combination with T215S and L210S. The T215S mutation has been showed to be associated with reversion of zidovudine resistance. The T215...
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Directory of Open Access Journals (Sweden)
Proudfoot Judith G
2012-11-01
Full Text Available Abstract Background The increasing burden on mental health services has led to the growing use of peer support in psychological interventions. Four theoretical mechanisms have been proposed to underpin effective peer support: advice grounded in experiential knowledge, social support, social comparison and the helper therapy principle. However, there has been a lack of studies examining whether these mechanisms are also evident in clinical populations in which interpersonal dysfunction is common, such as bipolar disorder. Method This qualitative study, conducted alongside a randomized controlled trial, examined whether the four mechanisms proposed to underpin effective peer support were expressed in the email exchange between 44 individuals newly-diagnosed with bipolar disorder and their Informed Supporters (n = 4, over the course of a supported online psychoeducation program for bipolar disorder. A total of 104 text segments were extracted and coded. The data were complemented by face-to-face interviews with three of the four Informed Supporters who participated in the study. Results Qualitative analyses of the email interchange and interview transcripts revealed rich examples of all four mechanisms. The data illustrated how the involvement of Informed Supporters resulted in numerous benefits for the newly-diagnosed individuals, including the provision of practical strategies for illness management as well as emotional support throughout the intervention. The Informed Supporters encouraged the development of positive relationships with mental health services, and acted as role models for treatment adherence. The Informed Supporters themselves reported gaining a number of benefits from helping, including a greater sense of connectedness with the mental health system, as well as a broader knowledge of illness management strategies. Conclusions Examples of the mechanisms underpinning effective peer support were found in the sample of emails from
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Kozhimannil, Katy B.; Arcaya, Mariana C.; Subramanian, S. V.
2014-01-01
Background Cesarean delivery is the most common inpatient surgery in the United States, where 1.3 million cesarean sections occur annually, and rates vary widely by hospital. Identifying sources of variation in cesarean use is crucial to improving the consistency and quality of obstetric care. We used hospital discharge records to examine the extent to which variability in the likelihood of cesarean section across US hospitals was attributable to individual women's clinical diagnoses. Methods and Findings Using data from the 2009 and 2010 Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project—a 20% sample of US hospitals—we analyzed data for 1,475,457 births in 1,373 hospitals. We fitted multilevel logistic regression models (patients nested in hospitals). The outcome was cesarean (versus vaginal) delivery. Covariates included diagnosis of diabetes in pregnancy, hypertension in pregnancy, hemorrhage during pregnancy or placental complications, fetal distress, and fetal disproportion or obstructed labor; maternal age, race/ethnicity, and insurance status; and hospital size and location/teaching status. The cesarean section prevalence was 22.0% (95% confidence interval 22.0% to 22.1%) among women with no prior cesareans. In unadjusted models, the between-hospital variation in the individual risk of primary cesarean section was 0.14 (95% credible interval 0.12 to 0.15). The difference in the probability of having a cesarean delivery between hospitals was 25 percentage points. Hospital variability did not decrease after adjusting for patient diagnoses, socio-demographics, and hospital characteristics (0.16 [95% credible interval 0.14 to 0.18]). A limitation is that these data, while nationally representative, did not contain information on parity or gestational age. Conclusions Variability across hospitals in the individual risk of cesarean section is not decreased by accounting for differences in maternal diagnoses. These findings highlight
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Körner, Henrike; Newman, Christy; Mao, Limin; Kippax, Susan; Kidd, Michael R; Saltman, Deborah
2008-09-01
This paper reports on in-depth interviews with general practitioners (GPs) about their views and experiences of diagnosing depression in gay men - some of whom are living with HIV - and the broader social contexts in which such a diagnosis is located. This analysis is a key outcome of a collaboration between social researchers, primary healthcare researchers, GPs and community partners, to investigate the management of depression in gay men in primary care settings. As the qualitative component of this project, semi-structured in-depth interviews were conducted with 16 GPs with high caseloads of gay men, in three geographical settings in Australia: Sydney, Adelaide and a rural-coastal town. GPs considered the diagnosis and management of depression to be an integral part of primary care, especially in gay male patients. They had a heightened sense of awareness that depression was common in the group of patients they were seeing. Central to diagnosing depression was the ongoing, long-term relationship GPs had with their gay male patients. GPs were vigilant and proactively inquired about depression, taking into account somatic, social and psychological indicators. In their approach to diagnosing depression, GPs considered not only the life circumstances of individual patients but also the broader social context of stigma related to homosexuality, and the effects that the HIV epidemic has had on individuals, especially on gay men who have been living with HIV for a long time.
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Nursing diagnoses and interventions for post-acute-phase battered women.
Carlson-Catalano, J
1998-01-01
To identify nursing diagnoses and interventions applicable for post-acute-phase battered women. Eight battered women were interviewed twice for 2 hours. Gordon's functional health patterns provided the framework for data collection. Fifty-three nursing diagnoses and 52 nursing interventions were indicated in the data; 24 nursing diagnoses and 26 nursing interventions were present in all participants' data. With the use of comprehensive interventions, nurses can make a major contribution to society by enabling battered women to move to a more protected lifestyle.
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Liber, Juliette M.; van Widenfelt, Brigit M.; Utens, Elisabeth M. W. J.; Ferdinand, Robert F.; van der Leeden, Adelinde J. M.; van Gastel, Willemijn; Treffers, Philip D. A.
2008-01-01
The present study compares an individual versus a group format in the delivery of manualised cognitive-behavioural therapy (FRIENDS) for children with anxiety disorders. Clinically referred children (aged 8 to 12) diagnosed with Separation Anxiety Disorder (n = 52), Generalised Anxiety Disorder (n =
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Andreassen, Bettina K; Myklebust, Tor Å; Haug, Erik S
2017-02-01
Reports from cancer registries often lack clinically relevant information, which would be useful in estimating the prognosis of individual patients with urothelial carcinoma of the urinary bladder (UCB). This article presents estimates of crude probabilities of death due to UCB and the expected loss of lifetime stratified for patient characteristics. In Norway, 10,332 patients were diagnosed with UCB between 2001 and 2010. The crude probabilities of death due to UCB were estimated, stratified by gender, age and T stage, using flexible parametric survival models. Based on these models, the loss in expectation of lifetime due to UCB was also estimated for the different strata. There is large variation in the estimated crude probabilities of death due to UCB (from 0.03 to 0.76 within 10 years since diagnosis) depending on age, gender and T stage. Furthermore, the expected loss of life expectancy is more than a decade for younger patients with muscle-invasive UCB and between a few months and 5 years for nonmuscle-invasive UCB. The suggested framework leads to clinically relevant prognostic risk estimates for individual patients diagnosed with UCB and the consequence in terms of loss of lifetime expectation. The published probability tables can be used in clinical praxis for risk communication.
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DEFF Research Database (Denmark)
Mouridsen, Svend-Erik; Hauschild, Karen-Marie
2009-01-01
Traditionally developmental language disorders (DLDs) have been studied with focus on psycholinguistic and cognitive implications, and little is known of the long-term psychosocial outcomes of individuals diagnosed with a DLD as children. The objective of this study was to compare the prevalence...... rates and types of personality disorders (PDs) in a clinical sample of 469 individuals diagnosed as children with DLD, with PDs in 2,345 matched controls from the general population without a known history of DLD, using data from the nation-wide Danish Psychiatric Central Register (DPCR). The average...... disorder, and degree of receptive and expressive language disorder) were not associated with a PD diagnosis in the DPCR at follow-up. Our results provide additional support to the notion that DLD is a marker of increased vulnerability to the development of a PD in adulthood and emphasizes that more...
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Genetic Analysis of 'PAX6-Negative' Individuals with Aniridia or Gillespie Syndrome
DEFF Research Database (Denmark)
Ansari, Morad; Rainger, Jacqueline; Hanson, Isabel M
2016-01-01
We report molecular genetic analysis of 42 affected individuals referred with a diagnosis of aniridia who previously screened as negative for intragenic PAX6 mutations. Of these 42, the diagnoses were 31 individuals with aniridia and 11 individuals referred with a diagnosis of Gillespie syndrome......) to PAX6 and one within a gene desert 5' (telomeric) to PITX2. Sequence analysis of the FOXC1 and PITX2 coding regions identified two plausibly pathogenic de novo FOXC1 missense mutations (p.Pro79Thr and p.Leu101Pro). No intragenic mutations were detected in PITX2. FISH mapping in an individual...... with Gillespie-like syndrome with an apparently balanced X;11 reciprocal translocation revealed disruption of a gene at each breakpoint: ARHGAP6 on the X chromosome and PHF21A on chromosome 11. In the other individuals with Gillespie syndrome no mutations were identified in either of these genes, or in HCCS...
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DEFF Research Database (Denmark)
Gradus, Jaimie L; Qin, Ping; Lincoln, Alisa K
2010-01-01
Adjustment disorder is a diagnosis given following a significant psychosocial stressor from which an individual has difficulty recovering. The individual's reaction to this event must exceed what would be observed among similar people experiencing the same stressor. Adjustment disorder is associa...... regression analyses revealed that those diagnosed with adjustment disorder had 12 times the rate of suicide as those without an adjustment disorder diagnosis, after controlling for history of depression diagnosis, marital status, income, and the matched factors....... is associated with suicidal ideation and suicide attempt. However the association between adjustment disorder and completed suicide has yet to be examined. The current study is a population-based case control study examining this association in the population of Denmark aged 15 to 90 years. All suicides...... in Denmark from 1994 to 2006 were included, resulting in 9,612 cases. For each case, up to 30 controls were matched on gender, exact date of birth, and calendar time, yielding 199,306 controls. Adjustment disorder diagnosis was found in 7.6% of suicide cases and 0.52% of controls. Conditional logistic...
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TBI-ROC Part Nine: Diagnosing TBI and Psychiatric Disorders
Elias, Eileen; Weider, Katie; Mustafa, Ruman
2011-01-01
This article is the ninth of a multi-part series on traumatic brain injury (TBI). It focuses on the process of diagnosing TBI and psychiatric disorders. Diagnosing traumatic brain injury can be challenging. It can be difficult differentiating TBI and psychiatric symptoms, as both have similar symptoms (e.g., memory problems, emotional outbursts,…
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Louwerse, Ilse; Huysmans, Maaike A; van Rijssen, H Jolanda; van der Beek, Allard J; Anema, Johannes R
2018-01-18
Today, work disability is one of the greatest social and labour market challenges for policy makers in most OECD countries, where on average, about 6% of the working-age population relies on disability benefits. Understanding of factors associated with long-term work disability may be helpful to identify groups of individuals at risk for disability benefit entitlement or continuing eligibility, and to develop effective interventions for these groups. The purpose of this study is to provide insight into the main diagnoses of workers who qualify for disability benefits and how these diagnoses differ in age, gender and education. Using a five-year follow-up, we examined the duration of disability benefits and how durations differ among individuals with various characteristics. We performed a cohort study of 31,733 individuals receiving disability benefits from the Dutch Social Security Institute (SSI) with a five-year follow-up. Data were collected from SSI databases. Information about disorders was assessed by an insurance physician upon benefit application. These data were used to test for significant relationships among socio-demographics, main diagnoses and comorbidity, and disability benefit entitlement and continuing eligibility. Mental disorders were the most frequent diagnosis for individuals claiming work disability. Diagnoses differed among age groups and education categories. Mental disorders were the main diagnosis for work disability for younger and more highly educated individuals, and physical disorders (generally musculoskeletal, cardiovascular and cancer) were the main diagnosis for older and less educated individuals. In 82% of the claims, the duration of disability benefit was five years or more after approval. Outflow was lowest for individuals with (multiple) mental disorders and those with comorbidity of mental and physical disorders, and highest for individuals with (multiple) physical disorders. The main diagnosis for persons entitled to
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Postnatal outcomes of prenatally diagnosed 45,X/46,XX.
Tokita, Mari J; Sybert, Virginia P
2016-05-01
High quality information is critical for informed decision-making in pregnancy following a prenatal diagnosis of sex chromosome aneuploidy. The goal of this study was to define the spectrum of outcomes in patients with prenatally diagnosed 45,X/46,XX mosaic Turner syndrome in order to provide a better basis for genetic counseling at the time of intrauterine diagnosis. Phenotype data for twenty-five patients with prenatally diagnosed 45,X/46,XX mosaicism were collected by retrospective chart review and, when possible, semi-structured telephone interview. Existing data from a cohort of 58 patients with postnatally diagnosed 45,X/46,XX mosaicism were used for comparison. Relative to those diagnosed postnatally, prenatal patients were more likely to have normal growth and normal secondary sexual development, less likely to manifest distinctive Turner syndrome features such as nuchal webbing and edema, and had significantly fewer renal defects. These differences underscore the need for a nuanced approach to prenatal counseling in cases of 45,X/46,XX mosaicism. © 2016 Wiley Periodicals, Inc.
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Bacterial vaginosis diagnosed by analysis of first-void-urine specimens
DEFF Research Database (Denmark)
Datcu, Raluca; Gesink, Dionne; Mulvad, Gert
2014-01-01
Bacterial vaginosis (BV) is traditionally diagnosed using vaginal samples. The aim of this study was to investigate whether BV can be diagnosed from first-void urine (FVU). Self-collected vaginal smears, vaginal swabs, and FVU were obtained from 176 women. BV was diagnosed by Nugent's criteria....... The FVU and vaginal swabs were analyzed by quantitative PCRs (qPCRs) for selected vaginal bacteria (Atopobium vaginae, Prevotella spp., Gardnerella vaginalis, bacterial vaginosis-associated bacterium 2, Eggerthella-like bacterium, "Leptotrichia amnionii," Megasphaera type 1), and all had an area under...
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Urinary incontinence nursing diagnoses in patients with stroke
Directory of Open Access Journals (Sweden)
Telma Alteniza Leandro
2015-12-01
Full Text Available Abstract OBJECTIVE Identifying the prevalence of Stress urinary incontinence (SUI, Urge urinary incontinence (UUI, Functional urinary incontinence (FUI, Overflow urinary incontinence (OUI and Reflex urinary incontinence (RUI nursing diagnoses and their defining characteristics in stroke patients. METHOD A cross-sectional study with 156 patients treated in a neurological clinic. Data were collected through interviews and forwarded to nurses for diagnostic inference. RESULTS 92.3% of the patients had at least one of the studied diagnoses; OUI showed the highest prevalence (72.4%, followed by FUI (53.2%, RUI (50.0%, UUI (41.0% and SUI (37.8%. Overdistended bladder and reports of inability to reach the toilet in time to avoid urine loss were the most prevalent defining characteristics. A statistically significant association of the defining characteristics with the studied diagnosis was verified. CONCLUSION The five incontinence diagnoses were identified in the evaluated patients, with different prevalence.
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Verification of Opacity and Diagnosability for Pushdown Systems
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Koichi Kobayashi
2013-01-01
Full Text Available In control theory of discrete event systems (DESs, one of the challenging topics is the extension of theory of finite-state DESs to that of infinite-state DESs. In this paper, we discuss verification of opacity and diagnosability for infinite-state DESs modeled by pushdown automata (called here pushdown systems. First, we discuss opacity of pushdown systems and prove that opacity of pushdown systems is in general undecidable. In addition, a decidable class is clarified. Next, in diagnosability, we prove that under a certain assumption, which is different from the assumption in the existing result, diagnosability of pushdown systems is decidable. Furthermore, a necessary condition and a sufficient condition using finite-state approximations are derived. Finally, as one of the applications, we consider data integration using XML (Extensible Markup Language. The obtained result is useful for developing control theory of infinite-state DESs.
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Ewart, Stephanie B.; Happell, Brenda; Bocking, Julia; Platania‐Phung, Chris; Stanton, Robert; Scholz, Brett
2017-01-01
Abstract Background People diagnosed with mental illness have shorter lives and poorer physical health, compared to the general population. These health inequities are usually viewed at an individual and clinical level, yet there is little research on the views of mental health consumers on clinical factors in broader contexts. Objective To elicit the views of consumers of mental health services regarding their physical health and experiences of accessing physical health‐care services. Design...
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Attitudes towards "disorders of sex development" nomenclature among affected individuals.
Johnson, Emilie K; Rosoklija, Ilina; Finlayson, Courtney; Chen, Diane; Yerkes, Elizabeth B; Madonna, Mary Beth; Holl, Jane L; Baratz, Arlene B; Davis, Georgiann; Cheng, Earl Y
2017-12-01
Although now commonly used in medicine, the updated "disorders of sex development" (DSD) nomenclature formally introduced in 2006 has never been universally accepted by members of the affected community, particularly advocacy groups. Use of this nomenclature by medical professionals may unintentionally negatively affect access to healthcare and research for individuals with DSD conditions. Among individuals affected by various DSD diagnoses, this study sought to (1) evaluate attitudes towards potentially controversial DSD terminology, (2) determine potential impact of terminology on how affected individuals access healthcare, and (3) explore alternate terms. A web-based survey was developed in collaboration with the AIS-DSDSG (Androgen Insensitivity Syndrome-DSD Support Group) leadership. AIS-DSDSG members (caregivers and affected individuals) were surveyed about attitudes towards DSD, potential impact on healthcare utilization, and alternate terms. A qualitative analysis of reasons for using/avoiding specific terms was performed. Surveys were completed by 202 out of 580 (35%) AIS-DSDSG members (61% affected, 39% caregivers; 16% non-gender binary; age range of affected individuals 0-86 years). Only 24% use disorder of sex development to describe themselves/their child. A majority (69%) had a negative emotional experience because of clinical use of nomenclature; 81% changed their care because of it. Preferred and non-preferred terms for clinical care and research are illustrated in the figure. Preferred diagnostic terms were intersex, variation in sex development, and difference of sex development (55%, 52%, and 50% liked/strongly liked, respectively). Disorder of sex development was not preferred (17% liked/strongly liked). About one-third reported that they would not attend a clinic named the Disorder of Sex Development Clinic. Overall, 81% provided qualitative comments; flexible terminology use was a key theme. These study findings are consistent with previous
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Deep learning aided decision support for pulmonary nodules diagnosing: a review.
Yang, Yixin; Feng, Xiaoyi; Chi, Wenhao; Li, Zhengyang; Duan, Wenzhe; Liu, Haiping; Liang, Wenhua; Wang, Wei; Chen, Ping; He, Jianxing; Liu, Bo
2018-04-01
Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades. The recent remarkable and significant progress in deep learning for pulmonary nodules achieved in both academia and the industry has demonstrated that deep learning techniques seem to be promising alternative decision support schemes to effectively tackle the central issues in pulmonary nodules diagnosing, including feature extraction, nodule detection, false-positive reduction, and benign-malignant classification for the huge volume of chest scan data. The main goal of this investigation is to provide a comprehensive state-of-the-art review of the deep learning aided decision support for pulmonary nodules diagnosing. As far as the authors know, this is the first time that a review is devoted exclusively to deep learning techniques for pulmonary nodules diagnosing.
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DEFF Research Database (Denmark)
Toftdahl, Nanna Gilliam; Nordentoft, Merete; Hjorthøj, Carsten
2016-01-01
abstract: Objective: It remains unclear whether there is an association between severity of cannabis use and psychotic symptom severity over time. Shedding light on this under-researched matter could have clinical implications for this patient group. Methods: This was a secondary analysis...... of a randomized, parallel-group, superiority, assessor-blinded trial. We followed 60 patients with dually diagnosed psychosis and cannabis use disorders from the Danish CapOpus trial, which included assessments at baseline, post-treatment (6 months) and 10 months. Cannabis use was registered by self...... with severe and persistent cannabis use (severe use group) had significantly higher scores, as compared to those with minor use, on the positive symptom (17.0, 95% CI [4.7–19.2] vs. 12.7, 95% CI [10.4–15.0], respectively, adjusted p
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Emotional suppression and depressive symptoms in women newly diagnosed with early breast cancer.
Li, Lingyan; Yang, Yanjie; He, Jincai; Yi, Jinyao; Wang, Yuping; Zhang, Jinqiang; Zhu, Xiongzhao
2015-10-24
Patients with breast cancer usually present varying levels of depressive symptoms. Emotional suppression, as a coping style, refers to an individual's ability to consciously control expression of negative emotions. Thus, emotional suppression is an important psychological factor related to depressive symptoms in patients with breast cancer. It has long been considered that compared to European and American women, Chinese women are more likely to ascribe to norms of negative emotion control for smooth social interaction. However, there is paucity of research focusing on emotional suppression among Chinese women with breast cancer. Thus the aims of the current study were (1) to investigate the incidence of depressive symptoms in women newly diagnosed with early breast cancer in Mainland China, and (2) to examine the relationships between emotional suppression and depressive symptoms in these patients. The Center for Epidemiological Studies Depression Scale (CES-D), the Beck Anxiety Inventory (BAI) and the Chinese version of the Courtauld Emotional Control Scale (CECS) were used to assess the level of depressive symptoms, anxiety symptoms and emotional suppression respectively in 247 women with early breast cancer and 362 healthy women. Analyses of variance were conducted to investigate group differences on depressive symptoms and emotional suppression. Bivariate correlations and Hierarchical regression analyses were performed to examine the effect of emotional suppression on depressive symptoms in participants after controlling the impact of group membership and anxiety level. (1) The incidence rates of clinical and severe depressive symptoms in patients were 36.4 and 36.0 % respectively. (2) Patients scored significantly higher than healthy women on CECS. (3) The scores on CECS were significantly associated with the total CES-D scores in all participants; Anger suppression significantly predicted the total CES-D scores. The majority of women newly diagnosed with
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Resilience and Associated Factors among Mainland Chinese Women Newly Diagnosed with Breast Cancer.
Directory of Open Access Journals (Sweden)
Zijing Wu
Full Text Available Resilience is the individual's ability to bounce back from trauma. It has been studied for some time in the U.S., but few studies in China have addressed this important construct. In mainland China, relatively little is known about the resilience of patients in clinical settings, especially among patients with breast cancer. In this study, we aimed to evaluate the level of resilience and identify predictors of resilience among mainland Chinese women newly diagnosed with breast cancer.A cross-sectional descriptive study was conducted with 213 mainland Chinese women newly diagnosed with breast cancer between November 2014 and June 2015. Participants were assessed with the Connor-Davidson Resilience Scale (CD-RISC, Social Support Rating Scale (SSRS, Medical Coping Modes Questionnaire (MCMQ, including 3 subscales: confrontation, avoidance, and acceptance-resignation, Herth Hope Index (HHI, and demographic and disease-related information. Descriptive statistics, bivariate analyses and multiple stepwise regression were conducted to explore predictors for resilience.The average score for CD-RISC was 60.97, ranging from 37 to 69. Resilience was positively associated with educational level, family income, time span after diagnosis, social support, confrontation, avoidance, and hope. However, resilience was negatively associated with age, body mass index (BMI, and acceptance-resignation. Multiple stepwise regression analysis indicated that hope (β = 0.343, P<0.001, educational level of junior college or above (β = 0.272, P<0.001, educational level of high school (β = 0.235, P<0.001, avoidance (β = 0.220, P<0.001, confrontation (β = 0.187, P = 0.001, and age (β = -0.108, P = 0.037 significantly affected resilience and explained 50.1% of the total variance in resilience.Women with newly diagnosed breast cancer from mainland China demonstrated particularly low resilience level, which was predicted by hope educational level, avoidance, confrontation
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Directory of Open Access Journals (Sweden)
Johan Källstrand
2010-05-01
Full Text Available Johan Källstrand1, Olle Olsson2, Sara Fristedt Nehlstedt1, Mia Ling Sköld1, Sören Nielzén21SensoDetect AB, Lund, Sweden; 2Department of Clinical Neuroscience, Section of Psychiatry, Lund University, Lund, SwedenAbstract: Abnormal auditory information processing has been reported in individuals with autism spectrum disorders (ASD. In the present study auditory processing was investigated by recording auditory brainstem responses (ABRs elicited by forward masking in adults diagnosed with Asperger syndrome (AS. Sixteen AS subjects were included in the forward masking experiment and compared to three control groups consisting of healthy individuals (n = 16, schizophrenic patients (n = 16 and attention deficit hyperactivity disorder patients (n = 16, respectively, of matching age and gender. The results showed that the AS subjects exhibited abnormally low activity in the early part of their ABRs that distinctly separated them from the three control groups. Specifically, wave III amplitudes were significantly lower in the AS group than for all the control groups in the forward masking condition (P < 0.005, which was not the case in the baseline condition. Thus, electrophysiological measurements of ABRs to complex sound stimuli (eg, forward masking may lead to a better understanding of the underlying neurophysiology of AS. Future studies may further point to specific ABR characteristics in AS individuals that separate them from individuals diagnosed with other neurodevelopmental diseases.Keywords: asperger syndrome, auditory brainstem response, forward masking, psychoacoustics
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Birdi, Gurkiran; Cooke, Richard; Knibb, Rebecca
2016-01-01
Background. Food allergy is related to poorer quality of life (QoL) and mental health of caregivers. Many parents diagnose food allergy in their child without seeking medical care and there is limited research on this group. This study investigated parental QoL and mental health in parents of children with parent-diagnosed food allergy (PA), medically diagnosed food allergy (MA), and a control group with no allergy (NA). Methods. One hundred and fifty parents from a general population completed validated measures of QoL, anxiety, depression, and stress. Results. Parents of children with food allergy (PA or MA) reported higher stress, anxiety, and depression than the control group (all p food allergy related QoL compared to parents of children with PA (p food allergy have significantly poorer mental health compared to healthy controls, irrespective of whether food allergy is medically diagnosed or not. It is important to encourage parents to have their child medically tested for food allergy and to recognise and refer for psychological support where needed.
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Nuclear Magnetic Resonance skull in Cuban families first diagnosed with Friedreich's ataxia
International Nuclear Information System (INIS)
Cruz Marinno, Tania; Alvarez Cuesta, Jose Alberto; Aguilera Rodriguez, Raul; Velazquez Perez, Luis
2011-01-01
Friedreich's ataxia is characterized by age of onset before 25 years, progressive ataxia, dysarthria, absent deep tendon reflexes and impaired vibration sense. This research was conducted in order to describe the imaging features of central nervous system structures in the early Cuban families diagnosed with the disease. A team of 0.23 Tesla-PANORAMA-Phylips Medical Systems, with a standard head coil, axial slices were obtained using 5mm thick FLAIR sequences, T1 and T2, and sagittal T1 and T2 in three individuals with confirmatory molecular diagnosis of Friedreich's ataxia and six healthy controls matched by age and sex. The morphological structures most affected are the cervical spinal cord, cerebellum and pons, which provides in vivo evidence that the disease leads to atrophy of these structures
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Diagnosing and reporting of occupational diseases: a quality improvement study
Spreeuwers, D.; de Boer, A. G. E. M.; Verbeek, J. H. A. M.; van Beurden, M. M.; van Dijk, F. J. H.
2008-01-01
AIM: To assess the need for quality improvement of diagnosing and reporting of noise-induced occupational hearing loss and occupational adjustment disorder. METHODS: Performance indicators and criteria for the quality of diagnosing and reporting were developed. Self-assessment questionnaires were
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Characteristics of Transgender Individuals Entering Substance Abuse Treatment
Heck, Nicholas C.; Sorensen, James L.
2014-01-01
Little is known about the needs or characteristics of transgender individuals in substance abuse treatment settings. Transgender (n=199) and non-transgender (cisgender, n=13440) individuals were compared on psychosocial factors related to treatment, health risk behaviors, medical and mental health status and utilization, and substance use behaviors within a database that documented individuals entering substance abuse treatment in San Francisco, CA from 2007–2009 using logistic and linear regression analyses (run separately by identified gender). Transgender men (assigned birth sex of female) differed from cisgender men across many psychosocial factors, including having more recent employment, less legal system involvement, greater incidence of living with a substance abuser, and greater family conflict, while transgender women (assigned birth sex of male) were less likely to have minor children than cisgender women. Transgender women reported greater needle use and HIV testing rates were greater among transgender women. Transgender men and women reported higher rates of physical health problems, mental health diagnoses, and psychiatric medications but there were no differences in service utilization. There were no differences in substance use behaviors except that transgender women were more likely to endorse primary methamphetamine use. Transgender individuals evidence unique strengths and challenges that could inform targeted services in substance abuse treatment. PMID:24561017
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Nes, Lise Solberg; Carlson, Charles R.; Crofford, Leslie J.; de Leeuw, Reny; Segerstrom, Suzanne C.
2011-01-01
Ability to self-regulate varies and self-regulatory strength is a limited source that can be depleted or fatigued. Research on the impact of individual differences on self-regulatory capacity is still scarce, and this study aimed to examine whether personality factors such as dispositional optimism, conscientiousness, and self-consciousness can impact or buffer self-regulatory fatigue. Participants were patients diagnosed with chronic multi-symptom illnesses (N = 50), or pain free matched con...
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The Digestive System and Nutritional Considerations for Individuals with Rett Syndrome
Directory of Open Access Journals (Sweden)
Meir Lotan
2006-01-01
Full Text Available Rett syndrome (RS is a neurodevelopmental syndrome of genetic origin that mainly affects females. Individuals diagnosed with RS exhibit a variety of functional difficulties that impair their quality of life. One of the affected systems is the digestive system, where 74% of persons with RS have abnormal functioning. The affected digestive system causes this population to present an array of problems, such as gastroesophageal reflux (GER, constipation, and malnutrition, leading to failure to thrive (FTT, which resolves in reduced functional ability. Due to the severe effects of the dysfunctional digestive system of individuals with RS, this article will describe the problems common to this population, as well as propose some clinical suggestions for intervention. .
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The Digestive System and Nutritional Considerations for Individuals with Rett Syndrome
Lotan, Meir; Zysman, Lilit
2006-01-01
Rett syndrome (RS) is a neurodevelopmental syndrome of genetic origin that mainly affects females. Individuals diagnosed with RS exhibit a variety of functional difficulties that impair their quality of life. One of the affected systems is the digestive system, where 74% of persons with RS have abnormal functioning. The affected digestive system causes this population to present an array of problems, such as gastroesophageal reflux (GER), constipation, and malnutrition, leading to failure to thrive (FTT), which resolves in reduced functional ability. Due to the severe effects of the dysfunctional digestive system of individuals with RS, this article will describe the problems common to this population, as well as propose some clinical suggestions for intervention. . PMID:17195872
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ADHD: the impact when not diagnosed
Souza,Isabella de; Mattos,Paulo; Pina,Camila; Fortes,Didia
2008-01-01
ADHD is a highly prevalent disorder in childhood with social, academic and familial difficulties when not diagnosed and treated correctly. The aim of this case report is to demonstrate the impairment of ADHD among generations of the same family.
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Directory of Open Access Journals (Sweden)
Pierre Bastin
Full Text Available BACKGROUND: There is little evidence on the effectiveness of services for the care of people with mental disorders among refugee populations. Médecins sans Frontières (MSF has established a mental health centre in a mixed urban-refugee population in Beirut to respond to the significant burden of mental health problems. Patients received comprehensive care through a multidisciplinary team. A cohort of people with common and severe mental disorders has been analysed between December 2008 and June 2011 to evaluate individual outcomes of treatment in terms of functionality. METHODS: All patients diagnosed with mental disorders were included in the study. The Global Assessment of Functioning (GAF and the Self Reporting Questionnaire-20 items (SRQ 20 were used as tools for baseline assessment, monitoring and evaluation of patients. Predictors of evolution of SRQ20 and GAF over visits were explored using a linear mixed model. RESULTS: Up to June 2011, 1144 patients were followed, 63.7% of them Lebanese, 31.8% Palestinians and 1.2% Iraqis. Females represented 64.2% of the patient population. Mean age was 39.2 years (28.5-46.5. The most frequent primary diagnoses were depressive disorders (28.8%, anxiety disorders (15.6% and psychosis (11.5%. A lower baseline SRQ20 score/higher baseline GAF score (indicators of severity, being diagnosed with anxiety (compared to being diagnosed with depression or psychosis and a higher level of education were associated with better outcomes. DISCUSSION: In this MSF program, we observed a significant decrease of SRQ20 individual scores and a significant increase of individual GAF scores. This corresponded to an improvement in the functionality of our patients. Analysis of the predictors of this positive evolution indicates that we need to adapt our model for the more severe and less educated patients. It also makes us reflect on the length of the individual follow-up. Further research could include a qualitative
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DEFF Research Database (Denmark)
Veloso, A.G.; Siersma, V.; Heldgaard, P.E.
2013-01-01
AIMS: To investigate whether long-term mortality or clinical outcomes differed between patients diagnosed with type 2 diabetes mellitus and presenting with HbA1c within or above normal range at time of diagnosis. METHODS: Data were from a population-based sample of 1136 individuals with newly dia...
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Directory of Open Access Journals (Sweden)
Sijing Chen
2017-03-01
Full Text Available Chromium has long been known as an enhancer of insulin action. However, the role of chromium in the development of type 2 diabetes mellitus (T2DM in humans remains controversial. The current study aimed to examine the associations of plasma chromium levels with T2DM and pre-diabetes mellitus (pre-DM. We conducted a case-control study involving 1471 patients with newly diagnosed T2DM, 682 individuals with newly diagnosed pre-DM, and 2290 individuals with normal glucose tolerance in a Chinese population from 2009 to 2014. Plasma chromium was measured by inductively coupled plasma mass spectrometry. Plasma chromium levels were lower in the T2DM and pre-DM groups than in the control group (median: 3.68 μg/L, 3.61 μg/L, 3.97 μg/L, respectively, p < 0.001. After adjustment for potential confounding factors, the odds ratios (95% confidence interval for T2DM across increasing quartiles of plasma chromium levels were 1 (referent, 0.67 (0.55–0.83, 0.64 (0.51–0.79, and 0.58 (0.46–0.73, respectively (p for trend <0.001. The corresponding odds ratios (95% confidence interval for pre-DM were 1 (referent, 0.70 (0.54–0.91, 0.67 (0.52–0.88, and 0.58 (0.43–0.78, respectively (p for trend < 0.001. Our results indicated that plasma chromium concentrations were inversely associated with T2DM and pre-DM in Chinese adults.
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Predictive validity of the Work Ability Index and its individual items in the general population.
Lundin, Andreas; Leijon, Ola; Vaez, Marjan; Hallgren, Mats; Torgén, Margareta
2017-06-01
This study assesses the predictive ability of the full Work Ability Index (WAI) as well as its individual items in the general population. The Work, Health and Retirement Study (WHRS) is a stratified random national sample of 25-75-year-olds living in Sweden in 2000 that received a postal questionnaire ( n = 6637, response rate = 53%). Current and subsequent sickness absence was obtained from registers. The ability of the WAI to predict long-term sickness absence (LTSA; ⩾ 90 consecutive days) during a period of four years was analysed by logistic regression, from which the Area Under the Receiver Operating Characteristic curve (AUC) was computed. There were 313 incident LTSA cases among 1786 employed individuals. The full WAI had acceptable ability to predict LTSA during the 4-year follow-up (AUC = 0.79; 95% CI 0.76 to 0.82). Individual items were less stable in their predictive ability. However, three of the individual items: current work ability compared with lifetime best, estimated work impairment due to diseases, and number of diagnosed current diseases, exceeded AUC > 0.70. Excluding the WAI item on number of days on sickness absence did not result in an inferior predictive ability of the WAI. The full WAI has acceptable predictive validity, and is superior to its individual items. For public health surveys, three items may be suitable proxies of the full WAI; current work ability compared with lifetime best, estimated work impairment due to diseases, and number of current diseases diagnosed by a physician.
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COMORBIDITY DIAGNOSES IN ALCOHOL DEPENDENT PATIENTS: DIFFERENCES AND DILEMMAS
Directory of Open Access Journals (Sweden)
Maja Rus-Makovec
2002-11-01
Full Text Available Background. In the presented study we followed the diagnostic procedures of comorbidity in alcohol dependent patients of in-patient treatment. The aim of the study was to evaluate the incidence of dual/triple diagnoses with alcohol dependent patients and to incorporate the diagnostic procedures in rutine work and in treatment planning.Material and methods. We were following the basic parameters of treatment of 469 patients (366 male, 102 female from July 1999 to July 2001. The diagnostic criteria according to ICD-10 were applied after at least four weeks of sobriety.Results. The most frequent additional diagnoses found were nicotine dependency, depressive and personal disorders. Main gender differences were found in diagnosis of depressive disorders and in dependency or abuse of prescripted drugs. Comparison of our results with literature data showed the greatest differences in diagnoses of cognitive, depressive, anxious data and dependency of other psychoactive substances.Conclusions. The comparison between the two time periods shows that stuff sensibility to diagnostic procedures of comorbidity states influences the frequency of diagnostic categories. The literature data review leads to impression of inconsistent diagnosing regarding the context and phylosophy of treatment context, stuff education and patient population.
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Directory of Open Access Journals (Sweden)
Delia L. Lang
2011-01-01
Full Text Available Objective. Despite recommendations for concurrent use of contraceptives and condoms to prevent unintended pregnancy and STIs, multimethod contraceptive use among women is poor. This study examined individual-, interpersonal-, and environmental-level factors that predict multimethod use among sexually active adolescent women diagnosed with psychological disorders. Methods. This multisite study analyzed data from 288 sexually active adolescent women who provided sociodemographic, psychosocial, and behavioral data related to birth control and condom use. Results. 34.7% of the participants reported multimethod use in the past three months. Controlling for empirically and theoretically relevant covariates, a multivariable logistic regression identified self-efficacy, multiple partners, pregnancy history, parental communication, parental norms about sex, and neighborhood cohesion as significant predictors of multimethod use. Conclusions. While continued targeted messages about multi-method contraceptive use are imperative at the individual level, an uptake in messages targeting interpersonal- and environmental-level factors such as adolescents' parents and the broader community is urgently needed.
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Harty, Seth C; Galanopoulos, Stavroula; Newcorn, Jeffrey H; Halperin, Jeffrey M
2013-01-01
To measure the degree to which childhood and adolescent ratings of aggression, attention, and delinquency are related to adolescent substance use outcomes in youth diagnosed with attention-deficit/hyperactivity disorder (ADHD). Childhood externalizing disorders have been shown to predict adolescent maladaptive substance use, but few studies have examined the differential predictive utility of two distinct dimensions of externalizing behavior: aggression and delinquency. Ninety-seven clinically referred children with ADHD initially took part in this research protocol when they were on average 9.05 years of age, and were seen again on average 9.30 years later. Participants' parents were administered the Child Behavior Checklist (CBCL) at baseline and follow-up, and youth completed the Youth Self Report (YSR) in adolescence. At follow-up, substance use severity and diagnosis were assessed using semi-structured psychiatric interviews administered separately to parents and adolescents. Linear and binary logistic regressions were used to determine the association of CBCL- and YSR-rated attention problems, aggression, and delinquency to adolescent substance use. Childhood and adolescent delinquency, but not aggression, as rated by parents and youths, predicted adolescent substance use disorders and substance use severity (all p delinquency and aggression with adolescent substance use, ratings of attention problems in childhood and adolescence were negatively associated with substance use outcome. Children with ADHD who exhibit high rates of delinquency are at risk for later substance use and may require targeted prevention, intervention, and follow-up services. Copyright © American Academy of Addiction Psychiatry.
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How Do Health Care Providers Diagnose Polycystic Ovary Syndrome (PCOS)?
... diagnosed? Is there a cure? What are the treatments? NICHD Research Information Research Goals Activities and Advances Scientific Articles Find a Study More Information Other FAQs Resources Home Health A to Z List Polycystic Ovary Syndrome (PCOS) About How is it diagnosed? Share Facebook ...
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How do Dutch general practitioners diagnose children's urinary tract infections?
Harmsen, M.; Wolters, R.J.; Wouden, J.C. van der; Grol, R.P.T.M.; Wensing, M.J.P.
2009-01-01
OBJECTIVE: To study which tests general practitioners used to diagnose a urinary tract infection (UTI) in children and which patient characteristics were associated with test choice. DESIGN: Retrospective chart review on the diagnosis of UTIs in children in Dutch general practices who were diagnosed
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Diagnosing autoimmune pancreatitis with the Unifying-Autoimmune-Pancreatitis-Criteria.
Schneider, Alexander; Michaely, Henrik; Rückert, Felix; Weiss, Christel; Ströbel, Philipp; Belle, Sebastian; Hirth, Michael; Wilhelm, Torsten J; Haas, Stephan L; Jesenofsky, Ralf; Schönberg, Stefan; Marx, Alexander; Singer, Manfred V; Ebert, Matthias P; Pfützer, Roland H; Löhr, J Matthias
We had developed the Unifying-Autoimmune-Pancreatitis-Criteria (U-AIP) to diagnose autoimmune pancreatitis (AiP) within the M-ANNHEIM classification of chronic pancreatitis. In 2011, International-Consensus-Diagnostic-Criteria (ICDC) to diagnose AiP have been published. We had applied the U-AIP long before the ICDC were available. The aims of the study were, first, to describe patients with AiP diagnosed by the U-AIP; second, to compare diagnostic accuracies of the U-AIP and other diagnostic systems; third, to evaluate the clinical applicability of the U-AIP. From 1998 until 2008, we identified patients with AiP using U-AIP, Japanese-, Korean-, Asian-, Mayo-HISORt-, Revised-Mayo-HISORt- and Italian-criteria. We retrospectively verified the diagnosis by ICDC and Revised-Japanese-2011-criteria, compared diagnostic accuracies of all systems and evaluated all criteria in consecutive patients with pancreatitis (2009 until 2010, Pancreas-Outpatient-Clinic-Cohort, n = 84). We retrospectively validated our diagnostic approach in consecutive patients with a pancreatic lesion requiring surgery (Surgical-Cohort, n = 98). Overall, we identified 21 patients with AiP. Unifying-Autoimmune-Pancreatitis-Criteria and ICDC presented the highest diagnostic accuracies (each 98.8%), highest Youden indices (each 0.95238), and highest proportions of diagnosed patients (each n = 20/21, U-AIP/ICDC vs. other diagnostic systems, p Pancreatitis-Criteria revealed a satisfactory clinical applicability and offered an additional approach to diagnose AiP. Copyright © 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.
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DEFF Research Database (Denmark)
Madsen, Ida E H; Hannerz, Harald; Nyberg, Solja T
2013-01-01
scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field. METHODS: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job...... using random effects meta-analysis. DISCUSSION: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled......BACKGROUND: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted "job strain") are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom...
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Suicide Attempt in a Recently Diagnosed HIV Positive Subject: Is ...
African Journals Online (AJOL)
Suicide Attempt in a Recently Diagnosed HIV Positive Subject: Is Pre and Post Counseling Still Being Adequately Practiced? ... A case of attempted suicide in a recently diagnosed HIV positive subject without adequate counseling is reported. Subject ... Key Words: Suicide Attempt, HIV/AIDS, Pre and Post test Counseling.
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Quality of life in children with undiagnosed and diagnosed asthma
van Gent, R.; van Essen, L.E.; Rovers, M.M.; Kimpen, J.L.; van der Ent, C.K.; de Meer, G.
This study describes the impact of undiagnosed and diagnosed asthma on quality of life in schoolchildren aged 7-10 years and their caregivers in a cross-sectional community-based study. Diagnosed asthma was defined as the parents' confirmation of a physician's diagnosis of asthma. Undiagnosed asthma
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Diagnosing risks in product-innovation projects
Halman, Johannes I.M.; Keizer, J.A.
A new method of diagnosing risks in product-innovation projects is introduced in the paper. The method is an improvement on existing risk methods used on product-innovation projects, such as potential problem analysis and failure mode and effects analysis. Technological, organizational and
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Diagnosing risks in product-innovation projects
Halman, J.I.M.; Keizer, J.A.
1994-01-01
A new method of diagnosing risks in product-innovation projects is introduced in the paper. The method is an improvement on existing risk methods used on product-innovation projects, such as potential problem analysis and failure mode and effects analysis. Technological, organizational and
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Pijnlijke temporomandibulaire disfuncties: diagnose en behandeling
Lobbezoo, F.; Aarab, G.; Knibbe, W.; Koutris, M.; Warnsinck, C.J.; Wetselaar, P.; Visscher, C.M.
2016-01-01
Painful temporomandibular disorders (TMD pain) are common among the general population. The most common sub diagnoses are myalgia (jaw-muscle pain) and arthralgia (temporomandibular joint pain). The aetiology of TMD pain has a multifactorial nature, and its diagnosis and possible treatment often
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Prevalence of nursing diagnoses in an intensive care unit
Directory of Open Access Journals (Sweden)
Vinicia de Holanda Cabral
2017-01-01
Full Text Available To identify the main nursing diagnostic titles used in the care of critically ill patients hospitalized in an Intensive Care Unit, verifying the presence thereof in the diagnoses of NANDA International’s Taxonomy II. Methods: descriptive and documental study, in which 69 medical records of patients aged over 18 years were consulted. Results: 22 nursing diagnostic titles were found; the most frequent was risk for infection (99.0%, risk for skin integrity (75.0% and risk for aspiration (61.0%. Most diagnoses were in the domains safety/ protection (43.0% and activity/rest (26.5%. Conclusions: authors identified the main nursing diagnostic titles used in the care of critically ill patients admitted to the Intensive Care Unit and the presence thereof in the diagnoses of NANDA International’s Taxonomy II.
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Diagnosing Homo sapiens in the fossil record.
Stringer, Christopher Brian; Buck, Laura Tabitha
2014-01-01
Diagnosing Homo sapiens is a critical question in the study of human evolution. Although what constitutes living members of our own species is straightforward, in the fossil record this is still a matter of much debate. The issue is complicated by questions of species diagnoses and ideas about the mode by which a new species is born, by the arguments surrounding the behavioural and cognitive separateness of the species, by the increasing appreciation of variation in the early African H. sapiens record and by new DNA evidence of hybridization with extinct species. This study synthesizes thinking on the fossils, archaeology and underlying evolutionary models of the last several decades with recent DNA results from both H. sapiens and fossil species. It is concluded that, although it may not be possible or even desirable to cleanly partition out a homogenous morphological description of recent H. sapiens in the fossil record, there are key, distinguishing morphological traits in the cranium, dentition and pelvis that can be usefully employed to diagnose the H. sapiens lineage. Increasing advances in retrieving and understanding relevant genetic data provide a complementary and perhaps potentially even more fruitful means of characterizing the differences between H. sapiens and its close relatives.
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Knowledge-based on-line vibration monitoring diagnose
International Nuclear Information System (INIS)
Johansson, L.G.; Karlsson, A.; Noeremark, A.
1990-01-01
ABB STAL developed some years ago a knowledge-based on-line vibration analysis system (working-name KOVA). KOVA is intended to work together with some type of vibration monitoring system, at present it is adapted to TVM 300. KOVA has no controlling function. It will only diagnose the actual situation and give the user explanations and proposals for actions to be taken. During the developing work, great experience has been gained of the features this type of system demands. This paper will present the outlines of the application and also discuss how to make diagnoses based both on general rules as well as on historical vibration cases for that particular unit (or identical units9. Another subject that this paper will outline, is the representation and evaluation of knowledge. KOVA serves as a decision-support system for the operator. Since KOVA will often give the operator more than one possible diagnosis as the cause of a fault, it is of great importance to give the operator comprehensive explanations and as many facts as possible. It is also important to rank the suggested diagnoses in some way. In KOVA these demands are effectively supported. The models and tools used to realize this functionality will be described in this paper
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[nursing Diagnoses And Most Common Collaboration Problems In High-risk Pregnancy].
Gouveia, Helga Geremias; Lopes, Maria Helena Baena de Moraes
2015-01-01
This study identified the demographic profile, obstetric and clinical diagnoses, nursing diagnosis and most common collaboration problem among pregnant women subject to high-risk at a hospital in São Paulo, Brazil. Data were collected by means of a form based on Gordon's Functional Health Patterns. Nursing diagnoses were determined on the basis of the NANDA (North American Nursing Diagnosis Association) taxonomy. The nursing diagnoses found in 50% or more of the pregnant women were: risk for ...
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Rakovitch, Eileen; Nofech-Mozes, Sharon; Hanna, Wedad; Baehner, Frederick L.; Saskin, Refik; Butler, Steven M.; Tuck, Alan; Sengupta, Sandip; Elavathil, Leela; Jani, Prashant A.; Bonin, Michel; Chang, Martin C.; Robertson, Susan J.; Slodkowska, Elzbieta; Fong, Cindy
2015-01-01
Validated biomarkers are needed to improve risk assessment and treatment decision-making for women with ductal carcinoma in situ (DCIS) of the breast. The Oncotype DX? DCIS Score (DS) was shown to predict the risk of local recurrence (LR) in individuals with low-risk DCIS treated by breast-conserving surgery (BCS) alone. Our objective was to confirm these results in a larger population-based cohort of individuals. We used an established population-based cohort of individuals diagnosed with DC...
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Björkenstam, Emma; Ekselius, Lisa; Burström, Bo; Kosidou, Kyriaki; Björkenstam, Charlotte
2017-08-01
Childhood adversity (CA) may increase the risk for later developing of personality disorder (PD). However, less is known about the association between cumulative CA and PD, and the role of childhood psychopathology and school performance. The current study examined the relationship between a range of CAs and a diagnosis of PD in young adulthood, and the roles of childhood psychopathology and school performance in this relationship. All individuals born in Stockholm County 1987-1991 (n = 107,287) constituted our cohort. Seven CAs were measured between birth and age 14: familial death, parental criminality, parental substance abuse and psychiatric morbidity, parental separation and/or single-parent household, household public assistance and residential instability. Individuals were followed from their 18th birthday until they were diagnosed with PD or until end of follow-up (December 31st 2011). Adjusted estimates of risk of PD were calculated as hazard ratios (HR) with 95% confidence intervals (CI). Associations were observed between cumulative CA and PD. During the follow-up 770 individuals (0.7%) were diagnosed with PD. Individuals exposed to 3+ CAs had the highest risks of being diagnosed with PD (HR 3.0, 95% CI 2.4-3.7). Childhood psychopathology and low school grades further increased the risk of PD among individuals exposed to CA. Cumulative CA is strongly associated with a diagnosis of PD in young adulthood. Our findings indicate that special attention should be given in schools and health services to children exposed to adversities to prevent decline in school performance, and to detect vulnerable individuals that may be on negative life-course trajectories.
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Assessment for markers of nephropathy in newly diagnosed type 2 ...
African Journals Online (AJOL)
Objective: To assess for markers of nephropathy in newly diagnosed type 2 diabetics, using blood pressure levels, endogenous creatinine clearance and urinary protein excretion as markers of renal disease. Study design: Ninety newly diagnosed type 2 diabetics were studied within 6 weeks of diagnosis. They were in ...
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How Do Health Care Providers Diagnose Vaginitis?
... used to diagnose vaginitis. 1 Centers for Disease Control and Prevention. (2010). Self-study STD ... Halvorson New Chief of Gynecologic Health and Disease Branch Division of Epidemiology, Statistics, ...
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Rogals, Monique J; Greenwood, Alexander I; Kwon, Jeahoo; Lu, Kun Ping; Nicholson, Linda K
2016-12-01
The peptidyl prolyl isomerase Pin1 has two domains that are considered to be its binding (WW) and catalytic (PPIase) domains, both of which interact with phosphorylated Ser/Thr-Pro motifs. This shared specificity might influence substrate selection, as many known Pin1 substrates have multiple sequentially close phosphoSer/Thr-Pro motifs, including the protein interleukin-1 receptor-associated kinase-1 (IRAK1). The IRAK1 undefined domain (UD) contains two sets of such neighboring motifs (Ser131/Ser144 and Ser163/Ser173), suggesting possible bivalent interactions with Pin1. Using a series of NMR titrations with 15N-labeled full-length Pin1 (Pin1-FL), PPIase, or WW domain and phosphopeptides representing the Ser131/Ser144 and Ser163/Ser173 regions of IRAK1-UD, bivalent interactions were investigated. Binding studies using singly phosphorylated peptides showed that individual motifs displayed weak affinities (> 100 μm) for Pin1-FL and each isolated domain. Analysis of dually phosphorylated peptides binding to Pin1-FL showed that inclusion of bivalent states was necessary to fit the data. The resulting complex model and fitted parameters were applied to predict the impact of bivalent states at low micromolar concentrations, demonstrating significant affinity enhancement for both dually phosphorylated peptides (3.5 and 24 μm for peptides based on the Ser131/Ser144 and Ser163/Ser173 regions, respectively). The complementary technique biolayer interferometry confirmed the predicted affinity enhancement for a representative set of singly and dually phosphorylated Ser131/Ser144 peptides at low micromolar concentrations, validating model predictions. These studies provide novel insights regarding the complexity of interactions between Pin1 and activated IRAK1, and more broadly suggest that phosphorylation of neighboring Ser/Thr-Pro motifs in proteins might provide competitive advantage at cellular concentrations for engaging with Pin1. © 2016 Federation of European
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DEFF Research Database (Denmark)
Lund, Martin; Bjerre, Thomas Abramovitz; Grønbæk, Henning
2016-01-01
This is the protocol for a review and there is no abstract. The objectives are as follows: To compare the accuracy of CEUS, CECT, MRI, and 18F-FDG PET-CT for diagnosing liver metastases in people with newly-diagnosed colorectal cancer. Potential sources of heterogeneity We will investigate...
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Directory of Open Access Journals (Sweden)
Jennifer J. Thomas
2014-01-01
Full Text Available Background. DSM-5 revisions have been criticized in the popular press for overpathologizing normative eating patterns—particularly among individuals with obesity. To evaluate the evidence for this and other DSM-5 critiques, we compared the point prevalence and interrater reliability of DSM-IV versus DSM-5 eating disorders (EDs among adults seeking weight-loss treatment. Method. Clinicians (n=2 assigned DSM-IV and DSM-5 ED diagnoses to 100 participants via routine clinical interview. Research assessors (n=3 independently conferred ED diagnoses via Structured Clinical Interview for DSM-IV and a DSM-5 checklist. Results. Research assessors diagnosed a similar proportion of participants with EDs under DSM-IV (29% versus DSM-5 (32%. DSM-5 research diagnoses included binge eating disorder (9%, bulimia nervosa (2%, subthreshold binge eating disorder (5%, subthreshold bulimia nervosa (2%, purging disorder (1%, night eating syndrome (6%, and other (7%. Interrater reliability between clinicians and research assessors was “substantial” for both DSM-IV (κ = 0.64, 84% agreement and DSM-5 (κ = 0.63, 83% agreement. Conclusion. DSM-5 ED criteria can be reliably applied in an obesity treatment setting and appear to yield an overall ED point prevalence comparable to DSM-IV.
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Eddy, Kamryn T.; Murray, Helen B.; Gorman, Mark J.
2014-01-01
Background. DSM-5 revisions have been criticized in the popular press for overpathologizing normative eating patterns—particularly among individuals with obesity. To evaluate the evidence for this and other DSM-5 critiques, we compared the point prevalence and interrater reliability of DSM-IV versus DSM-5 eating disorders (EDs) among adults seeking weight-loss treatment. Method. Clinicians (n = 2) assigned DSM-IV and DSM-5 ED diagnoses to 100 participants via routine clinical interview. Research assessors (n = 3) independently conferred ED diagnoses via Structured Clinical Interview for DSM-IV and a DSM-5 checklist. Results. Research assessors diagnosed a similar proportion of participants with EDs under DSM-IV (29%) versus DSM-5 (32%). DSM-5 research diagnoses included binge eating disorder (9%), bulimia nervosa (2%), subthreshold binge eating disorder (5%), subthreshold bulimia nervosa (2%), purging disorder (1%), night eating syndrome (6%), and other (7%). Interrater reliability between clinicians and research assessors was “substantial” for both DSM-IV (κ = 0.64, 84% agreement) and DSM-5 (κ = 0.63, 83% agreement). Conclusion. DSM-5 ED criteria can be reliably applied in an obesity treatment setting and appear to yield an overall ED point prevalence comparable to DSM-IV. PMID:25057413
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Radiological diagnoses of chelonians from 1929 to 1995
International Nuclear Information System (INIS)
Kuellinger, K.
2003-07-01
In the present study 200 x-rays of 116 chelonians taken during the period between 1929 and 1995 were re-diagnosed. The current diagnoses were compared with those made at the time of the x-rays. The anatomy and physiology of the chelonians are described in the bibliography and an overview is given of radiographic examination of chelonians, including radiographic anatomy and interpretation. The aetiology of some of the diseases frequently occurring in chelonians is described. This is followed by a list of the animals examined according to species, sex and age. An explanation is given of the new standardized method of evaluation. The results are described according to organ systems and, in addition, attention is given to radiographic technique, positioning and anti-radiation precautions. Some interesting cases were selected for special attention and illustrated using photographs of the x-rays. Furthermore, the degree of correspondence between the results obtained in this study with those found in reference literature is discussed. A comparison is made between the initial and current diagnoses. (author)
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Okamura, Erika; Suda, Naoto; Baba, Yoshiyuki; Fukuoka, Hiroki; Ogawa, Takuya; Ohkuma, Mizue; Ahiko, Nozomi; Yasue, Akihiro; Tengan, Toshimoto; Shiga, Momotoshi; Tsuji, Michiko; Moriyama, Keiji
2013-03-01
Objective : Ectrodactyly-ectodermal dysplasia-clefting syndrome is a congenital anomaly characterized by ectodermal dysplasia, ectrodactyly, cleft lip and palate, and lacrimal duct anomalies. Because this syndrome is frequently accompanied by a congenital lack of teeth, narrow palate, and malocclusion, comprehensive orthodontic intervention is required. Design : To highlight the specific dental and maxillofacial characteristics of ectrodactyly-ectodermal dysplasia-clefting syndrome, six Japanese individuals diagnosed with the syndrome are described here. Patients : The subjects consisted of two boys and four girls (age range, 6.0 to 13.9 years) diagnosed with ectrodactyly-ectodermal dysplasia-clefting syndrome by medical and dental specialists. Their conditions included ectodermal dysplasia (hypodontia, microdontia, enamel hypoplasia, and abnormalities in hair and nails), cleft lip and/or palate, and ectrodactyly. Cephalograms, panoramic x-rays, and dental casts were taken; systemic complications were recorded at the first visit to our dental hospital. Results : All individuals had severe oligodontia with 9 to 18 missing teeth. The missing teeth were mainly maxillary and mandibular incisors and second bicuspids, arranged in a symmetrical manner. Cephalometric analysis showed retruded and short maxilla due to cleft lip and/or palate. It is interesting that all individuals showed a characteristically shaped mandibular symphysis with a retruded point B. It is likely that this unusual symphyseal morphology is due to the lack of mandibular incisors. Conclusions : This study demonstrates the presence of severe oligodontia in the incisal and premolar regions and describes a characteristic maxillary and mandibular structure in Japanese individuals with ectrodactyly-ectodermal dysplasia-clefting syndrome.
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Duhaime, Ann-Christine; Beckwith, Jonathan G; Maerlender, Arthur C; McAllister, Thomas W; Crisco, Joseph J; Duma, Stefan M; Brolinson, P Gunnar; Rowson, Steven; Flashman, Laura A; Chu, Jeffrey J; Greenwald, Richard M
2012-12-01
Concussive head injuries have received much attention in the medical and public arenas, as concerns have been raised about the potential short- and long-term consequences of injuries sustained in sports and other activities. While many student athletes have required evaluation after concussion, the exact definition of concussion has varied among disciplines and over time. The authors used data gathered as part of a multiinstitutional longitudinal study of the biomechanics of head impacts in helmeted collegiate athletes to characterize what signs, symptoms, and clinical histories were used to designate players as having sustained concussions. Players on 3 college football teams and 4 ice hockey teams (male and female) wore helmets instrumented with Head Impact Telemetry (HIT) technology during practices and games over 2-4 seasons of play. Preseason clinical screening batteries assessed baseline cognition and reported symptoms. If a concussion was diagnosed by the team medical staff, basic descriptive information was collected at presentation, and concussed players were reevaluated serially. The specific symptoms or findings associated with the diagnosis of acute concussion, relation to specific impact events, timing of symptom onset and diagnosis, and recorded biomechanical parameters were analyzed. Data were collected from 450 athletes with 486,594 recorded head impacts. Forty-eight separate concussions were diagnosed in 44 individual players. Mental clouding, headache, and dizziness were the most common presenting symptoms. Thirty-one diagnosed cases were associated with an identified impact event; in 17 cases no specific impact event was identified. Onset of symptoms was immediate in 24 players, delayed in 11, and unspecified in 13. In 8 cases the diagnosis was made immediately after a head impact, but in most cases the diagnosis was delayed (median 17 hours). One diagnosed concussion involved a 30-second loss of consciousness; all other players retained
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Directory of Open Access Journals (Sweden)
M Vahid Dastjerdi
2018-02-01
Full Text Available Along with the development of laboratory methods for diagnosing addiction, concealment ways, either physically or chemically, for creating false results have been in progress. In this research based on the Laser Induced Breakdown Spectroscopy technique (LIBS and analyzing hair of addicted and normal people, we are proposing a new method to overcome problems in conventional methods and reduce possibility of cheating in the process of diagnosing addiction. For this purpose, at first we have sampled hair of 17 normal and addicted people and recorded 5 spectrums for each sample, overall 170 spectrums. After analyzing the recorded LIBS spectra and detecting the atomic and ionic lines as well as molecular bands, relative intensities of emission lines for Aluminum to Calcium (Al/Ca and Aluminum to Sodium (Al/Na were selected as the input variables for the Support Vector Machine model (SVM.The Radial Basis, Polynomial Kernel functions and a linear function were chosen for classifying the data in SVM model. The results of this research showed that by the combination of LIBS technique and SVM one can distinguish addicted person with precision of 100%. Because of several advantages of LIBS such as high speed analysis and being portable, this method can be used individually or together with available methods as an automatic method for diagnosing addiction through hair analysis.
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Sigmoid-vaginal fistula during bevacizumab treatment diagnosed by fistulography.
Hayashi, C; Takada, S; Kasuga, A; Shinya, K; Watanabe, M; Kano, H; Takayama, T
2016-12-01
There have been several reports describing rectovaginal fistula development after bevacizumab treatment, and these fistulas were diagnosed by CT scan or colonoscopy. We report a case of sigmoid-vaginal fistula diagnosed by fistulography. The case is a 53-year-old woman who was treated for chronic myelogenous leukaemia and gynaecological cancers 8 years previously. At 52 years of age, she was diagnosed with colon cancer and had a partial colectomy performed. One year after surgery, colon cancer recurred, and she was treated with anticancer agents, including bevacizumab. During chemotherapy, she complained of a foul smelling discharge from the vagina. Fistulography revealed a sigmoid-vaginal fistula. This is the first report of vaginal fistulography performed on a patient who was treated with bevacizumab. Fistulography may be useful for detecting sigmoid-vaginal fistula. © 2016 John Wiley & Sons Ltd.
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Individual socioeconomic status and breast cancer diagnostic stages: a French case-control study.
Orsini, Mattea; Trétarre, Brigitte; Daurès, Jean-Pierre; Bessaoud, Faiza
2016-06-01
Health inequalities have increased over the last 30 years. Our goal was to investigate the relationship between low individual socioeconomic status and poor breast cancer prognosis. Our hypothesis was: low socioeconomic status patients have a higher risk of being diagnosed with late stage breast cancer than high socioeconomic status ones due to delayed diagnosis. We conducted a matched case-control study on 619 women with breast cancer, living in the Hérault, a French administrative area. Both Cases and Controls were recruited among invasive cases diagnosed in 2011 and 2012 and treated in Hérault care centers. Cases were defined as patients with advanced stages. Controls were composed of early stage patients. Individual socioeconomic status was assessed using a validated individual score adapted to the French population and health care system. We observed that low socioeconomic status patients have a 2-fold risk of having late stage breast cancer regardless of cancer characteristics and detection mode (screening vs. clinical signs). One reason explaining those results could be that low socioeconomic status patients have less regular follow-up which can lead to later and poorer diagnosis. Follow-up is improved for women with a better awareness of breast cancer. Health policy makers could reduce health inequalities by reducing the delay in breast cancer diagnosis for low socioeconomic status women. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
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Psychological well-being among individuals aging with HIV: the value of social relationships.
Mavandadi, Shahrzad; Zanjani, Faika; Ten Have, Thomas R; Oslin, David W
2009-05-01
Utilizing a heterogenous sample of adults diagnosed with HIV infection, the current study sought to explore associations among age, various dimensions of social support, and psychological and functional well-being. Cross-sectional data capturing subjective and instrumental support, social interaction, behavioral health service utilization, and psychological well-being (ie, positive affect and depressive symptomatology), and physical functioning, were collected from 109 men and women living with HIV. To explore age group differences, participants were stratified by age (social interaction. However, older adults reported higher subjective support, which in turn was associated with lower depressive symptomatology, greater positive affect, and nonutilization of behavioral health services. More attention should be paid to the social environment of individuals diagnosed with HIV as the quality of social relationships may be particularly important for successful psychological adaptation to HIV.
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Pattern of social cognition deficits in individuals with borderline personality disorder.
Anupama V; Bhola, Poornima; Thirthalli, Jagadisha; Mehta, Urvakhsh Meherwan
2018-03-01
Social cognition deficits have been implicated in the affect regulation and interpersonal difficulties seen in borderline personality disorder (BPD). The study examined patterns of social cognition abilities, using self-report and task-based measures, among individuals diagnosed with BPD. The sample included a clinical group of 20 patients diagnosed with BPD and 20 age and gender-matched control group participants from the community with no psychiatric diagnosis. The measures included the Mentalization Questionnaire, the Reading the Mind in the Eyes Test and the Social Cognition Rating Tool in Indian Setting. Results indicated that the clinical group had lower self-reported mentalizing ability. Facial emotion recognition ability was significantly lower for the clinical group, particularly for photographs of the eye region with positive and neutral valences. The clinical group had significantly higher personalizing bias, and greater difficulties in social perception. The two groups did not differ on first and second order theory of mind, recognition of faux pas and externalizing bias. The results point to the links between social cognition deficits and interpersonal difficulties among persons with BPD. Implications include the need for pre-therapy assessment of the magnitude and patterns of social cognition difficulties in BPD, the development of culturally and ecologically valid assessments and the evaluation of interventions for social cognition vulnerabilities among individuals with BPD. Copyright © 2018 Elsevier B.V. All rights reserved.
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Directory of Open Access Journals (Sweden)
Catarina Jansson
2013-01-01
Full Text Available Background. Insomnia and disability pension are major health problems, but few population-based studies have examined the association between insomnia and risk of disability pension. Methods. We conducted a prospective nationwide cohort study based on Swedish population-based registers including all 5,028,922 individuals living in Sweden on December 31, 2004/2005, aged 17–64 years, and not on disability or old age pension. Those having at least one admission/specialist visit with a diagnosis of disorders of initiating and maintaining sleep (insomnias (ICD-10: G47.0 during 2000/2001–2005 were compared to those with no such inpatient/outpatient care. All-cause and diagnosis-specific incident disability pension were followed from 2006 to 2010. Incidence rate ratios (IRRs and 95% confidence intervals (CIs were estimated by Cox regression. Results. In models adjusted for prior sickness absence, sociodemographic factors, and inpatient/specialized outpatient care, associations between insomnia and increased risks of all-cause disability pension (IRR 1.35, 95% CI 1.09–1.67 and disability pension due to mental diagnoses (IRR 1.86, 95% CI 1.38–2.50 were observed. After further adjustment for insomnia medications these associations disappeared. No associations between insomnia and risk of disability pension due to cancer, circulatory, or musculoskeletal diagnoses were observed. Conclusion. Insomnia seems to be positively associated with all-cause disability pension and disability pension due to mental diagnoses.
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Yoo, Yongjoon; Park, Hyeon-Ju; Park, Soowon; Cho, Maeng Je; Cho, Seong-Jin; Lee, Ji Yeon
2018-01-01
Individuals with posttraumatic stress disorder (PTSD) are more prone to suicidal ideation and behavior. While those who have experienced interpersonal trauma exhibit more suicidality than those who have experienced non-interpersonal trauma, it is unclear how the traumatic effects are related to an individual’s personality characteristics. This study examined the association between interpersonal trauma and personality factors with suicidality, and elucidated the moderating role of interpersonal trauma in individuals with PTSD. The study included 6,022 participants from the Korean Epidemiologic Catchment Area Study 2011. The Korean Version of Composite International Diagnostic Interview was used for the survey, including the participants’ history of suicidality, the traumas they have experienced, and their PTSD symptoms. The 11-item version of the Big Five Inventory (BFI-11) was used to assess the participants’ personality factors. 76 individuals were diagnosed with PTSD, while 810 had been exposed to trauma but were not diagnosed with any DSM-IV mental disorder. Among the individuals with PTSD, those who had experienced interpersonal trauma were more likely to have suicidal ideation than those who had experienced non-interpersonal trauma (p = .020; odds ratio [OR] = 3.643; 95% confidence interval of OR = [1.226, 10.825]). High agreeableness and conscientiousness predicted less suicidality in those exposed to non-interpersonal trauma, while predicting more suicidality in those exposed to interpersonal trauma. Clinicians examining individuals with PTSD should pay closer attention to the trauma that they have experienced, as well as their personality factors, to provide appropriate treatment. PMID:29329352
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Psychiatric diagnoses are not mental processes: Wittgenstein on conceptual confusion.
Rosenman, Stephen; Nasti, Julian
2012-11-01
Empirical explanation and treatment repeatedly fail for psychiatric diagnoses. Diagnosis is mired in conceptual confusion that is illuminated by Ludwig Wittgenstein's later critique of philosophy (Philosophical Investigations). This paper examines conceptual confusions in the foundation of psychiatric diagnosis from some of Wittgenstein's important critical viewpoints. Diagnostic terms are words whose meanings are given by usages not definitions. Diagnoses, by Wittgenstein's analogy with 'games', have various and evolving usages that are connected by family relationships, and no essence or core phenomenon connects them. Their usages will change according to the demands and contexts in which they are employed. Diagnoses, like many psychological terms, such as 'reading' or 'understanding', are concepts that refer not to fixed behavioural or mental states but to complex apprehensions of the relationship of a variety of behavioural phenomena with the world. A diagnosis is a sort of concept that cannot be located in or explained by a mental process. A diagnosis is an exercise in language and its usage changes according to the context and the needs it addresses. Diagnoses have important uses but they are irreducibly heterogeneous and cannot be identified with or connected to particular mental processes or even with a unity of phenomena that can be addressed empirically. This makes understandable not only the repeated failure of empirical science to replicate or illuminate genetic, neurophysiologic, psychic or social processes underlying diagnoses but also the emptiness of a succession of explanatory theories and treatment effects that cannot be repeated or stubbornly regress to the mean. Attempts to fix the meanings of diagnoses to allow empirical explanation will and should fail as there is no foundation on which a fixed meaning can be built and it can only be done at the cost of the relevance and usefulness of diagnosis.
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Study on fatty liver diagnosed by abdominal ultrasonography and clinical laboratory findings
International Nuclear Information System (INIS)
Yang, Jeong Hwa
2006-01-01
The study obtained the following conclusions by making a comparative study on fatty liver diagnosed by abdominal ultrasonography and clinical laboratory findings. I surveyed the value of abdominal ultrasound in 400 patients without clinical symptoms at C Health Clinic Center, Seoul. Compare with blood pressure was high (systolic/diastolic) in 7.5%/4.5% on persons who were diagnosed fatty liver. At the time of the diagnosis, Total cholesterol level was increased in fatty liver patients, HDL-cholesterol level was high in fatty liver patients. And Trigryceride level was increased in fatty liver persons, LDL-cholesterol was high in fatty liver persons. SGOT level was increased in 5.5% on patients who were diagnosed fatty liver, 0% on persons who were normal and SGPT level was high in 29.5% on people who were diagnosed fatty liver, 0% on patients who were diagnosed normal
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Study on fatty liver diagnosed by abdominal ultrasonography and clinical laboratory findings
Energy Technology Data Exchange (ETDEWEB)
Yang, Jeong Hwa [Cheju Halla College, Cheju (Korea, Republic of)
2006-03-15
The study obtained the following conclusions by making a comparative study on fatty liver diagnosed by abdominal ultrasonography and clinical laboratory findings. I surveyed the value of abdominal ultrasound in 400 patients without clinical symptoms at C Health Clinic Center, Seoul. Compare with blood pressure was high (systolic/diastolic) in 7.5%/4.5% on persons who were diagnosed fatty liver. At the time of the diagnosis, Total cholesterol level was increased in fatty liver patients, HDL-cholesterol level was high in fatty liver patients. And Trigryceride level was increased in fatty liver persons, LDL-cholesterol was high in fatty liver persons. SGOT level was increased in 5.5% on patients who were diagnosed fatty liver, 0% on persons who were normal and SGPT level was high in 29.5% on people who were diagnosed fatty liver, 0% on patients who were diagnosed normal.
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Individualized measurement of irrational beliefs in remitted depressives.
Solomon, Ari; Arnow, Bruce A; Gotlib, Ian H; Wind, Brian
2003-04-01
Recent reviews of cognitive theories of depression have noted that individualized assessment strategies might help to resolve mixed findings regarding the stability of depressotypic beliefs and attitudes. We describe encouraging results for an individualized measure of one such cognitive construct, irrational beliefs. Twenty depression-prone women (recurrent major depressives in full remission) and twenty closely matched never-depressed controls completed leading forced-choice measures of irrational beliefs (the Belief Scale; BS) and sociotropy-autonomy (The Revised Personal Style Inventory), as well as the Specific Demands on Self Scale (SDS). The BS requires participants to rate their agreement with twenty preselected statements of irrational beliefs, while the SDS focuses on whether participants harbor any strongly held irrational beliefs, even if uncommon or idiosyncratic. Consistent with previous research, there were no group differences on the traditional measure of irrational beliefs. In contrast, depression-prone participants strongly exceeded controls on the SDS, and this difference persisted after controlling for residual depression, anxiety symptoms, anxiety diagnoses, sociotropy, and autonomy. These findings provide some initial support for a key assumption of the rational-emotive model of depression, and, more broadly, suggest that individualized assessment strategies may help researchers capture the core negative beliefs of asymptomatic individuals, even in the absence of mood or cognitive priming. Copyright 2003 Wiley Periodicals, Inc. J Clin Psychol 59: 439-455, 2003.
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Mental disorder diagnoses among children and adolescents who use antipsychotic drugs.
Nesvåg, Ragnar; Hartz, Ingeborg; Bramness, Jørgen G; Hjellvik, Vidar; Handal, Marte; Skurtveit, Svetlana
2016-09-01
Antipsychotic drugs are used increasingly by children and adolescents and there is concern about off-label use. We aimed to study which substances, and for which mental disorder diagnoses, antipsychotic drugs were prescribed to 0-18-year-old boys and girls in Norway. Linked data from the national health registry for prescription drugs in 2010 and mental disorder diagnoses in 2008-2012 were used to study the prevalence of antipsychotic drug use, the type of antipsychotic drug substances used, mental disorder diagnoses in users and distribution of drugs per diagnostic category across gender. In total, 0.18% of Norwegian children and adolescents were prescribed antipsychotic drugs during 2010, of which there were more boys (0.23%) than girls (0.13%). Risperidone was the most frequently used substance among boys (57.4%) and girls (32.3%), followed by aripiprazole (19.4%) in boys and quetiapine (27.4%) in girls. The most common mental disorder diagnoses among male users were hyperkinetic (49.9%) and autism spectrum disorder (27.1%), while anxiety disorders (41.5%) and depressive illness (33.6%) were most common among female users. A schizophrenia-like psychosis diagnosis was given to 11.1% of the male and 18.2% of the female users. A hyperkinetic disorder was diagnosed among 56.9% and 52.4% of the male risperidone and aripiprazole users, respectively. Among female quetiapine users, 57.1% were diagnosed with anxiety disorders and 52.4% with depressive illness. These results demonstrate that children and adolescents who use antipsychotic drugs are predominantly diagnosed with non-psychotic mental disorders such as hyperkinetic disorder among boys and anxiety disorder or depressive illness among girls. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.
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Weng, W; Liang, Y; Kimball, E S; Hobbs, T; Kong, S; Sakurada, B; Bouchard, J
2016-07-01
Objective To explore trends in demographics, comorbidities, anti-diabetic drug usage, and healthcare utilization costs in patients with newly-diagnosed type 2 diabetes mellitus (T2DM) using a large US claims database. Methods For the years 2007 and 2012, Truven Health Marketscan Research Databases were used to identify adults with newly-diagnosed T2DM and continuous 12-month enrollment with prescription benefits. Variables examined included patient demographics, comorbidities, inpatient utilization patterns, healthcare costs (inpatient and outpatient), drug costs, and diabetes drug claim patterns. Results Despite an increase in the overall database population between 2007-2012, the incidence of newly-diagnosed T2DM decreased from 1.1% (2007) to 0.65% (2012). Hyperlipidemia and hypertension were the most common comorbidities and increased in prevalence from 2007 to 2012. In 2007, 48.3% of newly-diagnosed T2DM patients had no claims for diabetes medications, compared with 36.2% of patients in 2012. The use of a single oral anti-diabetic drug (OAD) was the most common diabetes medication-related claim (46.2% of patients in 2007; 56.7% of patients in 2012). Among OAD monotherapy users, metformin was the most commonly used and increased from 2007 (74.7% of OAD monotherapy users) to 2012 (90.8%). Decreases were observed for sulfonylureas (14.1% to 6.2%) and thiazolidinediones (7.3% to 0.6%). Insulin, predominantly basal insulin, was used by 3.9% of patients in 2007 and 5.3% of patients in 2012. Mean total annual healthcare costs increased from $13,744 in 2007 to $15,175 in 2012, driven largely by outpatient services, although costs in all individual categories of healthcare services (inpatient and outpatient) increased. Conversely, total drug costs per patient were lower in 2012 compared with 2007. Conclusions Despite a drop in the rate of newly-diagnosed T2DM from 2007 to 2012 in the US, increased total medical costs and comorbidities per individual patient suggest that
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HIV Trends in the United States: Diagnoses and Estimated Incidence.
Hall, H Irene; Song, Ruiguang; Tang, Tian; An, Qian; Prejean, Joseph; Dietz, Patricia; Hernandez, Angela L; Green, Timothy; Harris, Norma; McCray, Eugene; Mermin, Jonathan
2017-02-03
The best indicator of the impact of human immunodeficiency virus (HIV) prevention programs is the incidence of infection; however, HIV is a chronic infection and HIV diagnoses may include infections that occurred years before diagnosis. Alternative methods to estimate incidence use diagnoses, stage of disease, and laboratory assays of infection recency. Using a consistent, accurate method would allow for timely interpretation of HIV trends. The objective of our study was to assess the recent progress toward reducing HIV infections in the United States overall and among selected population segments with available incidence estimation methods. Data on cases of HIV infection reported to national surveillance for 2008-2013 were used to compare trends in HIV diagnoses, unadjusted and adjusted for reporting delay, and model-based incidence for the US population aged ≥13 years. Incidence was estimated using a biomarker for recency of infection (stratified extrapolation approach) and 2 back-calculation models (CD4 and Bayesian hierarchical models). HIV testing trends were determined from behavioral surveys for persons aged ≥18 years. Analyses were stratified by sex, race or ethnicity (black, Hispanic or Latino, and white), and transmission category (men who have sex with men, MSM). On average, HIV diagnoses decreased 4.0% per year from 48,309 in 2008 to 39,270 in 2013 (Pyear (Pyears, overall, the percentage of persons who ever had received an HIV test or had had a test within the past year remained stable; among MSM testing increased. For women, all 3 incidence models corroborated the decreasing trend in HIV diagnoses, and HIV diagnoses and 2 incidence models indicated decreases among blacks and whites. The CD4 and Bayesian hierarchical models, but not the stratified extrapolation approach, indicated decreases in incidence among MSM. HIV diagnoses and CD4 and Bayesian hierarchical model estimates indicated decreases in HIV incidence overall, among both sexes and all
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available ... options further? Fertility Preservation - Where Does It Fit? Options for Fertility Preservation The following diagram gives a brief description of fertility preservation options available to children diagnosed with cancer before and ...
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Telephone calls by individuals with cancer.
Flannery, Marie; McAndrews, Leanne; Stein, Karen F
2013-09-01
To describe symptom type and reporting patterns found in spontaneously initiated telephone calls placed to an ambulatory cancer center practice. Retrospective, descriptive. Adult hematology oncology cancer center. 563 individuals with a wide range of oncology diagnoses who initiated 1,229 telephone calls to report symptoms. Raw data were extracted from telephone forms using a data collection sheet with 23 variables obtained for each phone call, using pre-established coding criteria. A literature-based, investigator-developed instrument was used for the coding criteria and selection of which variables to extract. Symptom reporting, telephone calls, pain, and symptoms. A total of 2,378 symptoms were reported by telephone during the four months. At least 10% of the sample reported pain (38%), fatigue (16%), nausea (16%), swelling (12%), diarrhea (12%), dyspnea (10%), and anorexia (10%). The modal response was to call only one time and to report only one symptom (55%). Pain emerged as the symptom that most often prompted an individual to pick up the telephone and call. Although variation was seen in symptom reporting, an interesting pattern emerged with an individual reporting on a solitary symptom in a single telephone call. The emergence of pain as the primary symptom reported by telephone prompted educational efforts for both in-person clinic visit management of pain and prioritizing nursing education and protocol management of pain reported by telephone. Report of symptoms by telephone can provide nurses unique insight into patient-centered needs. Although pain has been an important focus of education and research for decades, it remains a priority for individuals with cancer. A wide range in symptom reporting by telephone was evident.
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Wakefield, Jerome C; First, Michael B
2012-02-01
The Diagnostic and Statistical Manual of Mental Disorders (DSM) definition of mental disorder requires that symptoms be caused by a dysfunction in the individual; when dysfunction is absent, symptoms represent normal-range distress or eccentricity and, if diagnosed as a mental disorder, are false positives. We hypothesized that because of psychiatry's lack of direct laboratory tests to distinguish dysfunction from normal-range distress, the context in which symptoms occur (eg, lack of imminent danger in a panic attack) is often essential to determining whether symptoms are caused by a dysfunction. If this is right, then the DSM diagnostic criteria should include many contextual criteria added to symptom syndromes to prevent dysfunction false positives. Despite their potential importance, such contextual criteria have not been previously reviewed. We, thus, systematically reviewed DSM categories to establish the extent of such uses of contextual criteria and created a typology of such uses. Of 111 sampled categories, 68 (61%) used context to prevent dysfunction false positives. Contextual criteria fell into 7 types: (1) exclusion of specific false-positive scenarios; (2) requiring that patients experience preconditions for normal responses (eg, requiring that individuals experience adequate sexual stimulation before being diagnosed with sexual dysfunctions); (3) requiring that symptoms be disproportionate relative to circumstances; (4) for childhood disorders, requiring that symptoms be developmentally inappropriate; (5) requiring that symptoms occur in multiple contexts; (6) requiring a substantial discrepancy between beliefs and reality; and (7) a residual category. Most DSM categories include contextual criteria to eliminate false-positive diagnoses and increase validity of descriptive criteria. Future revisions should systematically evaluate each category's need for contextual criteria. Copyright © 2012 Elsevier Inc. All rights reserved.
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Exercise recommendations in patients with newly diagnosed fibromyalgia.
Wilson, Brad; Spencer, Horace; Kortebein, Patrick
2012-04-01
To evaluate exercise recommendations in patients newly diagnosed with fibromyalgia. A retrospective chart review. A public university rheumatology clinic. Patients newly diagnosed with fibromyalgia (N = 122). Frequency and type of exercise recommendations. The mean (standard deviation) age of these patients with fibromyalgia was 45 ± 12 years; 91% were women. Exercise was recommended as part of the documented treatment plan in 47% of these patients (57/122); only 3 patients had a documented contraindication for exercise. Aquatic exercise was most frequently recommended (56% [32/57]), followed by combined aquatic-aerobic exercise (26% [15/57]), and, infrequently, aerobic exercise only (5% [3/57]); only 7% of these patients (4/57) were referred for physical therapy. The primary method of communication was verbal discussion (94% [54/57]). Although there is well-documented evidence that exercise is beneficial for patients with fibromyalgia, we found that less than half of patients with newly diagnosed fibromyalgia in our study were provided recommendations to initiate an exercise program as part of their treatment plan. Further investigation of these findings are warranted, including evaluation of other university and community rheumatology practices as well as that of other physicians caring for patients with fibromyalgia. However, our findings indicate that there appears to be an opportunity to provide more specific and practical education regarding the implementation of an exercise regimen for patients with newly diagnosed fibromyalgia. Physiatrists may be particularly well suited to manage the exercise component of patients with fibromyalgia because of their specialized training in exercise prescription. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
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Subset of nursing diagnoses for the elderly in Primary Health Care
Directory of Open Access Journals (Sweden)
Jorge Wilker Bezerra Clares
2016-04-01
Full Text Available Abstract OBJECTIVE To develop a subset of nursing diagnoses for the elderly followed in primary health care based on the bank of terms for clinical nursing practice with the elderly, in the International Classification for Nursing Practice (ICNP(r version 2013, and on the Model of Nursing Care. METHOD Descriptive study developed in sequential steps of construction and validation of the bank of terms, elaboration of the nursing diagnoses based on the guidelines of the International Council of Nurses and the bank of terms, and categorization of diagnostics according to the Care Model. RESULTS The total of 127 nursing diagnoses were elaborated from 359 validated terms, distributed according to the basic human needs. CONCLUSION It is expected that these diagnoses will form the basis for the planning of nursing care and use of a unified language for documentation of clinical nursing practice with the elderly in primary care.
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An analysis of occupational dysphonia diagnosed in the North-East of Poland.
Kosztyła-Hojna, Bozena; Rogowski, Marek; Ruczaj, Jerzy; Pepiński, Witold; Lobaczuk-Sitnik, Anna
2004-01-01
The objective of the study was to evaluate factors predisposing to occupational dysphonia in a group of professional voice users. The study involved 374 patients treated in the Clinic of Otolaryngology and the Phoniatric Outpatient Clinic, Department of Otolaryngology, Medical University of Białystok in 1999--2001. Group I consisted of 309 patients qualified as professional voice users. The obtained results were compared with those yielded in a group of 65 persons of other occupations (group II). All the diagnosed patients neither smoked nor abused alcohol. Tobacco smokers, patients with chronic diseases of the respiratory system or individuals exposed to irritating vapors were excluded from the study. The clinical evaluation included phoniatric examinations with use of videoendoscopy (VIS) and videolaryngostroboscopy (VLSS) of the larynx. Based on the larynx endoscopic image the voice organ pathology was diagnosed in the patients as functional and/or organic dysphonia. The former comprised hyperfunctional or hypofunctional dysphonia and insufficiency of the glottis and the latter other laryngeal disturbances. In the statistical analysis chi2 parametric test of independence for two averages was used. Female teachers of primary and lower secondary schools, mean age 43 years, prevailed in the group of professional voice users, in which functional dysphonia was more common. In this group, the onset of organic changes was earlier than that of functional changes and was manifested by soft vocal nodules, edematous and inflammatory changes in the vocal fold mucosa. Functional dysphonia of 3 degrees, 4 degrees and even 5 degrees predominated in the group of professional voice users in the course of their employment.
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No Circadian Variation in Surgeons' Ability to Diagnose Acute Appendicitis
DEFF Research Database (Denmark)
Jørgensen, Anders Bech; Amirian, Ilda; Kehlet Watt, Sara
2016-01-01
OBJECTIVE: To examine if there were circadian variations in surgeons' ability to diagnose acute appendicitis. DESIGN: Retrospective database study of all patients admitted to an acute surgical procedure under the potential diagnosis of acute appendicitis in a 4-year period. The day was divided...... patients were included. There were no age limitations or selection in sex. RESULTS: There was no significant difference in the ability to diagnose appendicitis in day-evening hours vs night hours (p = 0.391), nor was any significant difference found on weekdays (Monday-Thursday) vs weekends (Friday...... of imaging had no effect on the ability to diagnose appendicitis. Male sex showed a higher probability of the diagnosis being appendicitis compared with other or no pathology (odds ratio: 3.094; p
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Jansson, Catarina; Alexanderson, Kristina; Kecklund, Göran; Åkerstedt, Torbjörn
2013-11-01
Insomnia is a large health problem. In some prior studies, positive associations between insomnia symptoms and sickness absence have been observed. There is, however, no previous nationwide cohort study of clinically diagnosed insomnia and risk of incident sickness absence. Prospective nationwide cohort study based on Swedish population-based registers including all 4,956,358 individuals registered as living in Sweden on 31 December 2004/2005, aged 17-64 years, not on disability pension, old-age pension or on-going sickness absence. Those having insomnia inpatient or outpatient care, defined as having at least one admission/specialist visit with a main or secondary diagnosis of disorders of initiating and maintaining sleep [insomnias] (ICD-10: G47.0) during 2000/2001-2005, were compared to those with no such care. All-cause and diagnosis-specific incident sickness absence were followed during 2006-2010. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards regression. In models adjusted for prior sickness absence, socio-demographic factors and inpatient and specialized outpatient care, associations between insomnia and increased risks of all-cause sickness absence (IRR 1.18, 95% CI 1.04-1.35) and sickness absence due to mental diagnoses (IRR 1.75, 95% CI 1.36-2.25) were observed. After further adjustment for insomnia medications these associations disappeared. No associations between insomnia and risk of sickness absence due to cancer, circulatory or musculoskeletal diagnoses, or injuries, were observed. In this nationwide cohort study, we observed increased risks of all-cause sickness absence and sickness absence due to mental diagnoses after adjustment for several potential confounders that disappeared after further adjustment for insomnia medications.
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Chen, Yicong; Chen, Xinran; Dang, Ge; Zhao, Yuhui; Ouyang, Fubing; Su, Zhenpei; Zeng, Jinsheng
2015-03-01
The diagnosis of hypertension, as recommended by most guidelines, is determined by systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg. A threshold-based definition of hypertension, however, ignores sex and age, pathophysiology, and disparities in patient-specific conditions. Moreover, the harmful effects of hypertension-induced target organ damage cannot be ignored. Although the principle of individualization for hypertension management is recommended, especially for stroke prevention, how to practice it in a clinical setting has not been clearly elaborated. Therefore, we put forward a proposal for individualized hypertension management incorporating target organ damage, the main harmful effect of hypertension. We propose that hypertension should be diagnosed when an individual's blood pressure exceeds some difference from their own baseline in young adulthood, accompanied by any hypertension-induced target organ damage, confirmed by various detection methods. Application of this proposal to stroke prevention will hopefully strengthen the principle of individualized hypertension management. ©2015 Wiley Periodicals, Inc.
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Teaching Chinese psychiatrists to make reliable dissociative disorder diagnoses.
Fan, Qing; Yu, Junhan; Ross, Colin A; Keyes, Benjamin B; Dai, Yunfei; Zhang, Tianhong; Wang, Lanlan; Xiao, Zeping
2011-09-01
The aim of the study was to assess the outcome of an educational effort by two North American experts in dissociative disorders to teach Chinese psychiatrists to make reliable dissociative disorder diagnoses. In the final phase of the educational effort, 569 patients at Shanghai Mental Health Center completed the Chinese version of the Dissociative Experiences Scale (DES). Patients were then randomly selected in different proportions according to their DES scores: 96 selected patients were then assessed with the Dissociative Disorders Interview Schedule (DDIS) and clinical diagnostic interviews based on DSM-IV criteria. According to the clinical diagnostic interviews, 28 (4.9%) patients were diagnosed as having dissociative disorders. Agreement between the American experts and Chinese psychiatrists for presence or absence of a dissociative disorder was 0.75 using Cohen's kappa. Dissociative disorders can be diagnosed in China with good inter-rater reliability. The authors describe the steps taken to achieve this outcome.
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Foley, Elizabeth; Baillie, Andrew; Huxter, Malcolm; Price, Melanie; Sinclair, Emma
2010-01-01
Objective: This study evaluated the effectiveness of mindfulness-based cognitive therapy (MBCT) for individuals with a diagnosis of cancer. Method: Participants (N = 115) diagnosed with cancer, across site and stage, were randomly allocated to either the treatment or the wait-list condition. Treatment was conducted at 1 site, by a single…
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Headache diagnoses among Iraq and Afghanistan war veterans enrolled in VA: a gender comparison.
Carlson, Kathleen F; Taylor, Brent C; Hagel, Emily M; Cutting, Andrea; Kerns, Robert; Sayer, Nina A
2013-01-01
To examine the prevalence and correlates of headache diagnoses, by gender, among Iraq and Afghanistan War Veterans who use Department of Veterans Affairs (VA) health care. Understanding the health care needs of recent Veterans, and how these needs differ between women and men, is a priority for the VA. The potential for a large burden of headache disorders among Veterans seeking VA services exists but has not been examined in a representative sample. We conducted a historical cohort study using national VA inpatient and outpatient data from fiscal year 2011. Participants were all (n = 470,215) Iraq and Afghanistan War Veteran VA users in 2011; nearly 13% were women. We identified headache diagnoses using International Classification of Diseases (ICD-9) diagnosis codes assigned during one or more VA inpatient or outpatient encounters. Descriptive analyses included frequencies of patient characteristics, prevalence and types of headache diagnoses, and prevalence of comorbid diagnoses. Prevalence ratios (PR) with 95% confidence intervals (CI) were used to estimate associations between gender and headache diagnoses. Multivariate models adjusted for age and race. Additional models also adjusted for comorbid diagnoses. In 2011, 56,300 (11.9%) Veterans received a headache-related diagnosis. While controlling for age and race, headache diagnoses were 1.61 times more prevalent (95% CI = 1.58-1.64) among women (18%) than men (11%). Most of this difference was associated with migraine diagnoses, which were 2.66 times more prevalent (95% CI = 2.59-2.73) among women. Cluster and post-traumatic headache diagnoses were less prevalent in women than in men. These patterns remained the same when also controlling for comorbid diagnoses, which were common among both women and men with headache diagnoses. The most prevalent comorbid diagnoses examined were depression (46% of women with headache diagnoses vs 40% of men), post-traumatic stress disorder (38% vs 58%), and back
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available ... Not an option if there is a high risk of ovarian metastases. Discuss with your doctor. b ... an IRB . Resources For more information about infertility risk and fertility preservation options for children diagnosed with ...
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available ... for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult survivors of childhood cancer ... study approved by an IRB . Resources For more information about infertility risk and fertility preservation options for ...
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Fertility Preservation for Children Diagnosed with Cancer
... Skip to main content SaveMyFertility An Online Fertility Preservation Toolkit for Patients and Their Providers Open menu ... with Cancer You are here Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation for ...
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available ... be fertility preservation options available and having your child see a reproductive specialist in a timely manner ... there are options for preserving fertility in your child diagnosed with cancer. You may be focused on ...
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Ye, Jing-Rong; Zang, Wan-Chun; Su, Xue-Li; Lu, Hong-Yan; Hao, Ming-Qiang; Xin, Ruo-Lei; Chen, Guo-Min; He, Xiong; Zeng, Yi
2014-03-01
This study aims to analyze the molecular epidemiological characteristics of HIV-1 strains prevailing among men who have sex with men (MSM) in Beijing, China. The pol gene fragments from 250 newly diagnosed HIV-1-infected MSM individuals during 2006-2010 in Beijing were amplified by RT-nested PCR, sequenced, and phylogenetically analyzed. HIV-1 pol gene from 189 individuals were amplified and analyzed; 81 (42. 9%), 3 (1. 6%), 2 (1.0%), 88 (46. 6%), and 15 (7.9%) individuals were infected with HIV-1 subtypes B, B', C, CRF01_AE, and CRF07_BC, respectively. The subtypes B and CRF01_AE could both be grouped into two clusters, and CRFO7_BC strains shared high homology and were presumed to originate from a common ancestor. The HIV-1 circulating in MSM in Beijing had a lower genetic diversity than in heterosexuals. The HIV-1 epidemic (2006-2010) in MSM in Beijing was actually a rapid spread of HIV-1 CRF01 AE and B, or rather native strains of the two viruses.
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Santabárbara, Javier; Gracia-García, Patricia; Pírez, Guillermo; López-Antón, Raúl; De La Cámara, Concepcion; Ventura, Tirso; Pérez-Sastre, Marina; Lobo, Elena; Saz, Pedro; Marcos, Guillermo; Lobo, Antonio
2016-11-01
To explore the possibility that the mortality risk of mild cognitive impairment (MCI) as diagnosed using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria (DSM-5-MCI) will be higher than using Petersen's criteria (P-MCI) and to report the population-attributable fraction (PAF) of mortality due to MCI. A representative community sample of 4,803 individuals aged 55 or more years was interviewed and then followed for 17 years. Standardized instruments were used in the assessment, including the Geriatric Mental State-AGECAT, and research psychiatrists diagnosed P-MCI and DSM-5-MCI cases following operationalized criteria. Mortality information was obtained from the official population registry. Kaplan-Meier age-adjusted survival curves were built for the MCI diagnostic groups, and Cox proportional hazards regression models were used to calculate the hazard ratio of death in participants with MCI relative to those without. We also estimated the PAF of mortality due to specific MCI diagnostic groups. Compared with noncases, the mortality rate ratio was approximately double in DSM-5-MCI individuals (2.3) than in P-MCI individuals (1.2). In the multivariate statistical analysis, a significant association between each diagnostic category and mortality was observed but was only maintained in the final model in DSM-5-MCI cases (hazard ratio: 1.24). The PAF of mortality due to MCI was approximately 1% in both MCI categories. The mortality risk in comparison with noncases was higher in DSM-5-MCI than in P-MCI. The PAF of mortality in DSM-5-MCI individuals was ~ 1% over a 17-year period. Copyright © 2016. Published by Elsevier Inc.
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Subcutaneous emphysema, a different way to diagnose
Directory of Open Access Journals (Sweden)
Bruno José da Costa Medeiros
Full Text Available Summary Introduction: Subcutaneous emphysema (SE is a clinical condition that occurs when air gets into soft tissues under the skin. This can occur in any part of the body depending on the type of pathology. The most common site is under the skin that covers the chest wall or neck. It is characterized by painless swelling of tissues. The classic clinical sign is a crackling sensation upon touch, resembling that of touching a sponge beneath your fingers. Objective: To describe a new way to diagnose subcutaneous emphysema. Method: Our finding was a matter of serendipity while inspecting a patient with subcutaneous emphysema using a stethoscope. Instead only hearing the patient's chest, the stethoscope was gently pressed against the skin with SE and so we were able to detect a different sound. Results: This new way to diagnose subcutaneous emphysema consists in pressing the diaphragm part of stethoscope against the patient's skin where SE is supposed to be. Thus, we are able to hear a sound of small bubbles bursting. Crackle noise has an acoustic emission energy that varies between 750-1,200 Hz, considered high frequency. Conclusion: Although currently the use of imaging methods is widespread worldwide, we would like to strengthen the value of clinical examination. Auscultation is an essential diagnostic method that has become underestimated with the advances of healthcare and medicine as a whole. We therefore propose a different approach to diagnose SE.
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Diagnosing method for nuclear power plant
International Nuclear Information System (INIS)
Sonoda, Yukio.
1991-01-01
When an abnormality occurs in a nuclear power plant, the abnormality is diagnosed, at present, graphic waveforms obtained by applying signal processing such as high speed Fourier transformation, etc. to fluctuation ingredients (noises) of process signals such as neutron fluxes, and plotting a power spectral density relative to a frequency. However, expert technical knowledges are required for interpreting the waveforms and it is difficult for field operators and persons for maintenance to judge them. Then, in the present invention, patterns of the power spectral density are inputted for pattern recognition by using a neural net so that any of patterns experienced in the past can be identified. If an unknown pattern appears, it is automatically studied for identification in subsequent cases. Then, the known abnormality of the plant can be monitored and causes thereof can be identified in an early stage, as well as it is possible to diagnose unknown abnormalities in subsequent situation. This method is effective for monitoring and maintaining the integrity, and can avoid unnecessary scram to improve plant operation factor. (N.H.)
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Diagnosing ignition with DT reaction history
International Nuclear Information System (INIS)
Wilson, D. C.; Bradley, P. A.; Herrmann, H. W.; Cerjan, C. J.; Salmonson, J. D.; Spears, B. K.; Hatchet, S. P. II; Glebov, V. Yu.
2008-01-01
A full range DT reaction history of an ignition capsule, from 10 9 to 10 20 neutrons/ns, offers the opportunity to diagnose fuel conditions hundreds of picoseconds before and during burn. The burn history begins with a sharp rise when the first shock reaches the center of the capsule. The level of this jump reflects the combined shock strength and the adiabat of DT fuel. Changes to the four laser pulses driving the capsule implosion which are large enough to degrade the yield make measurable changes to the reaction history. Low mode asymmetries grow during convergence but change the reaction history during the final ∼100 ps. High mode asymmetry or turbulence mixing affects only the reaction history within ∼50 ps of peak burn rate. A capsule with a tritium fuel layer containing a small amount of deuterium (∼1%) creates a reaction history similar to the ignition capsule, but without the final ignition burn. A combination of gas Cerenkov detectors and the neutron temporal diagnostic could be capable of diagnosing the full history of ignition and tritium rich capsules.
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Sudden unexpected death in children with a previously diagnosed cardiovascular disorder
Polderman, Florens N.; Cohen, Joeri; Blom, Nico A.; Delhaas, Tammo; Helbing, Wim A.; Lam, Jan; Sobotka-Plojhar, Marta A.; Temmerman, Arno M.; Sreeram, Narayanswani
2004-01-01
BACKGROUND: It is known that children with previously diagnosed heart defects die suddenly. The causes of death are often unknown. OBJECTIVE: The aim of the study was to identify all infants and children within the Netherlands with previously diagnosed heart disease who had a sudden unexpected death
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Sudden unexpected death in children with a previously diagnosed cardiovascular disorder
Polderman, F.N.; Cohen, Joeri; Blom, N.A.; Delhaas, T.; Helbing, W.A.; Lam, J.; Sobotka-Plojhar, M.A.; Temmerman, Arno M.; Sreeram, N.
2004-01-01
Background: It is known that children with previously diagnosed heart defects die suddenly. The causes of death are often unknown. Objective: The aim of the study was to identify all infants and children within the Netherlands with previously diagnosed heart disease who had a sudden unexpected death
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Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia
DEFF Research Database (Denmark)
Saglio, Giuseppe; Kim, Dong-Wook; Issaragrisil, Surapol
2010-01-01
Nilotinib has been shown to be a more potent inhibitor of BCR-ABL than imatinib. We evaluated the efficacy and safety of nilotinib, as compared with imatinib, in patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia (CML) in the chronic phase.......Nilotinib has been shown to be a more potent inhibitor of BCR-ABL than imatinib. We evaluated the efficacy and safety of nilotinib, as compared with imatinib, in patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia (CML) in the chronic phase....
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First diagnosed lethal case of lyssavirus infection in Primorsky krai
Leonova, G.; Chentsova, I.; Petukhova, S.; Somova, L.; Belikov, S.; Kondratov, I.; Kryilova, N.; Plekhova, N.; Pavlenko, E.; Romanova, E.; Matsak, V.; Smirnov, G.; Novikov, D.
2010-01-01
The paper provides data of comprehensive study of lethal case of lyssavirus infection first diagnosed in Yakovlevsky municipal district in Primorsky Krai. The data of epidemiologic analysis (contact with a rattle mouse), clinical picture and results of virologic, morphological and molecular genetic tests allow attributing this case to lyssavirus infection. This is the first diagnosed case of lyssavirus infection in the Siberia and Far East.
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available ... content SaveMyFertility An Online Fertility Preservation Toolkit for Patients and Their Providers Open menu Reprotopia_Main_Menu ... Cancer Fertility Preservation for Children Diagnosed with Cancer Patient Pocket Guides Patient Pocket Guides Patient Guides Fertility ...
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A Study on Test Technology to Diagnose the Power Apparatus
Energy Technology Data Exchange (ETDEWEB)
Kim, K H; Kang, Y S; Jeon, Y K; Lee, W Y; Kang, D S; Kyu, H S; Sun, J H; Jo, K H [Korea Electrotechnology Research Institute (Korea, Republic of); Jung, J S; Mun, Y T; Lee, K H; Jung, E H; Kim, J H [Korea Water Resources Corporation (Korea, Republic of)
1997-02-01
In this study, we have educated KOWACO(Korea Water Resources Corporation) specialists about the insulation diagnostic technology and trained them the insulation diagnostic test and estimation method of power apparatus. The main results of this study are as follows; A. Education of basic high-voltage engineering. B. Research of insulation characteristic and deterioration mechanism in power apparatus C. Discussion on high-voltage test standard specifications. D. Study on insulation deterioration diagnostics in power apparatus. E. Field testing of insulation diagnosis in power apparatus. F. Engineering of insulation diagnostic testing apparatus to diagnose power apparatus. KOWACO specialists are able to diagnose insulation diagnostic test of power apparatus through this study. As they have instruments to diagnose power apparatus, they can do the test and estimation of the power apparatus insulation diagnosis. (author). refs., figs., tabs.
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Prevalence and characteristics of the metabolic syndrome among newly diagnosed hypertensive patients
Osuji, Charles U.; Omejua, Emeka G.
2012-01-01
Background: Cardiovascular disease risk factors have a tendency to cluster. The presence of such a cluster in an individual has been designated the metabolic syndrome (MetS). There is a paucity of reports of the prevalence of MetS in hypertensive patients in south east Nigeria. This study was undertaken to determine the prevalence of the metabolic syndrome (MetS) among newly diagnosed hypertensive patients using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria in a tertiary healthcare centre in South East Nigeria. Materials and Methods: A population of 250 consecutive newly diagnosed adult hypertensive patients (126 males and 124 females) was evaluated. Blood pressure and anthropometric measurements were done using standardized techniques. After an overnight fast, blood samples were taken for glucose and lipid profile assays. The NCEP ATP III criteria were then applied for the diagnosis of MetS. Results: The prevalence of the MetS among the study population was 31.2%. The sex-specific prevalences were 15.1% and 47.6% among male and female patients respectively. A large number of the patients (40.4%) were at a high potential risk of developing the MetS as they already met 2 of the criteria. The MetS prevalence increased progressively from 14.3% through 23.8%, in the patients aged 24-33years and 34-43 years, respectively to a peak (40.4%) among those aged 44-53 years before declining in those aged 54-63 years (31.8%), 64-73 years (33.3%) and 74 years and above (20.6%). Central obesity was the most common component of the MetS being present in 50.4% of patients (28.6% of males and 72.6% of females). Of the other components, low HDL-C was present in 38.8% (26.2% of males and 51.6% of females), elevated FBS in 12.8% (6.3% of males and 19.4% of females) and elevated triglycerides in 8.8% (11.9% of males and 5.6% of females). Conclusion: The prevalence of the MetS is high among newly diagnosed hypertensive patients in Nnewi
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Lung ultrasonography to diagnose pneumothorax of the newborn.
Liu, Jing; Chi, Jing-Han; Ren, Xiao-Ling; Li, Jie; Chen, Ya-Juan; Lu, Zu-Lin; Liu, Ying; Fu, Wei; Xia, Rong-Ming
2017-09-01
To explore the reliability and accuracy of lung ultrasound for diagnosing neonatal pneumothorax. This study was divided into two phases. (1) In the first phase, from January 2013 to June 2015, 40 patients with confirmed pneumothorax had lung ultrasound examinations performed to identify the sonographic characteristics of neonatal pneumothorax. (2) In the second phase, from July 2015 to August 2016, lung ultrasound was undertaken on 50 newborn infants with severe lung disease who were suspected of having pneumothorax, to evaluate the sonographic accuracy and reliability to diagnose pneumothorax. (1) The main ultrasonic manifestations of pneumothorax are as follows: ① lung sliding disappearance, which was observed in all patients (100%); ② the existence of the pleural line and the A-line, which was also observed in all patients (100%); ③ the lung point, which was found in 75% of the infants with mild-moderate pneumothorax but not found to exist in 25% of the severe pneumothorax patients; ④ the absence of B-lines in the area of the pneumothorax (100% of the pneumothorax patients); and ⑤ no lung consolidation existed in the area of the pneumothorax (100% of the pneumothorax patients). (2) The accuracy and reliability of the lung sonographic signs of lung sliding disappearance as well as the existence of the pleural line and the A-line in diagnosing pneumothorax were as follows: 100% sensitivity, 100% specificity, 100% positive predictive value, and 100% negative predictive value. When the lung point exists, the diagnosis is mild-moderate pneumothorax, whereas if no lung point exists, the diagnosis is severe pneumothorax. Lung ultrasound is accurate and reliable in diagnosing and ruling out neonatal pneumothorax and, in our study, was found to be as accurate as chest X-ray. Copyright © 2017 Elsevier Inc. All rights reserved.
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DEFF Research Database (Denmark)
Erlangsen, Annette; Zarit, S.H.; Conwell, Yeates
2008-01-01
OBJECTIVE: The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders. DESIGN: Event-history analysis using time-varying covariates. SETTING: Population-based record linkage. PARTICIPANTS: All individuals...... who are aged 70 or older with dementia have a threefold higher risk than persons with no dementia. The time shortly after diagnosis is associated with an elevated suicide risk. The risk among persons with dementia remains significant when controlling for mood disorders. As many as 26% of the men...... aged 50+ living in Denmark (N=2,474,767) during January 1, 1990 through December 31, 2000. MEASUREMENTS: Outcome of interest is suicide. Relative risks are calculated based on person-days spent in each stratum. RESULTS: A total of 18,648,875 person-years were observed during the 11-year study period...
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available ... Skip to main content SaveMyFertility An Online Fertility Preservation Toolkit for Patients and Their Providers Open menu ... with Cancer You are here Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation for ...
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Diagnosing patients with longstanding shoulder joint pain
DEFF Research Database (Denmark)
Nørregaard, J; Krogsgaard, M R; Lorenzen, T
2002-01-01
OBJECTIVE: To examine the interobserver agreement of commonly used clinical tests and diagnoses in patients with shoulder pain, and the accuracy of these tests and ultrasonographic findings in comparison with arthroscopic findings. METHODS: Eighty six patients with longstanding shoulder joint pain...
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Hotta, Kiyohiko; Fukasawa, Yuichiro; Wada, Yoshiki; Fukuzawa, Nobuyuki; Seki, Toshimori; Harada, Hiroshi
2017-08-01
Among organ transplant recipients, cytomegalovirus (CMV) commonly results in various types of infection such as pneumonitis, hepatitis, and enterocolitis. However, CMV peritonitis is very rare and difficult to diagnose owing to lack of visible clinical signs. We present a case of a 35-year-old female kidney recipient who developed abdominal pain and urinary retention caused by CMV peritonitis. To our knowledge, this is the first case report of CMV peritonitis after organ transplantation to be diagnosed through histopathological examination. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Inhalant-Abuse Myocarditis Diagnosed by Cardiac Magnetic Resonance.
Dinsfriend, William; Rao, Krishnasree; Matulevicius, Susan
2016-06-01
Multiple reports of toxic myocarditis from inhalant abuse have been reported. We now report the case of a 23-year-old man found to have toxic myocarditis from inhalation of a hydrocarbon. The diagnosis was made by means of cardiac magnetic resonance imaging with delayed enhancement. The use of cardiac magnetic resonance to diagnose myocarditis has become increasingly common in clinical medicine, although there is not a universally accepted criterion for diagnosis. We appear to be the first to document a case of toxic myocarditis diagnosed by cardiac magnetic resonance. In patients with a history of drug abuse who present with clinical findings that suggest myocarditis or pericarditis, cardiac magnetic resonance can be considered to support the diagnosis.
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Diagnostic quality and observer variation in radiographic diagnoses of approximal caries
International Nuclear Information System (INIS)
Espelid, I.; Tveit, A.B.
1986-01-01
The aim of the study was to compare observer variations, observer strategy, and diagnostic quality with regard to radiographic caries diagnoses made at different depth levels. Qualitative assessment of approximal carious lesions on the basis of radiographs were made for sound (n=28) and carious (n=123) lesions by seven dentists. The inter- and intra-observer variations were lowest when lesions were diagnosed as being in the outermost parts of the teeth. The frequency of false positive scores was lower when dentin was examined as compared with enamel. The quality of radiographic diagnoses showed small variations (p>0.05) when different levels of pulpal depths were interpreted
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Ropponen, Annina; Samuelsson, Åsa; Alexanderson, Kristina; Svedberg, Pia
2013-09-16
Occupations and psychosocial working conditions have rarely been investigated as predictors of disability pension in population-based samples. This study investigated how occupational groups and psychosocial working conditions are associated with future disability pension due to musculoskeletal diagnoses, accounting for familial factors in the associations. A sample of 24,543 same-sex Swedish twin individuals was followed from 1993 to 2008 using nationwide registries. Baseline data on occupations were categorized into eight sector-defined occupational groups. These were further used to reflect psychosocial working conditions by applying the job strain scores of a Job Exposure Matrix. Cox proportional hazard ratios (HR) were estimated. During the 12-year (average) follow-up, 7% of the sample was granted disability pension due to musculoskeletal diagnoses. Workers in health care and social work; agriculture, forestry and fishing; transportation; production and mining; and the service and military work sectors were two to three times more likely to receive a disability pension than those in the administration and management sector. Each single unit decrease in job demands and each single unit increase in job control and social support significantly predicted disability pension. Individuals with high work strain or an active job had a lower hazard ratio of disability pension, whereas a passive job predicted a significantly higher hazard ratio. Accounting for familial confounding did not alter these results. Occupational groups and psychosocial working conditions seem to be independent of familial confounding, and hence represent risk factors for disability pension due to musculoskeletal diagnoses. This means that preventive measures in these sector-defined occupational groups and specific psychosocial working conditions might prevent disability pension due to musculoskeletal diagnoses.
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Vervenne, W. L.; Bakker, P. J.; Stalpers, L. J.; Bosch, D. A.
2000-01-01
In two men aged 19 and 24 years, a rare malignant intracranial germ cell tumour was diagnosed in the pineal gland region and in the second patient in a suprasellar position as well. Although histological confirmation is required in general to diagnose a malignancy, obtaining it can be difficult and
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Lundberg, Marcus; Lindqvist, Andreas; Wierup, Nils; Krogvold, Lars; Dahl-Jørgensen, Knut; Skog, Oskar
2017-01-01
To elucidate the etiology of type 1 diabetes, the affected pancreas needs to be thoroughly characterized. Pancreatic innervation has been suggested to be involved in the pathology of the disease and a reduction of sympathetic innervation of the islets was recently reported. In the present study, we hypothesized that parasympathetic innervation would be altered in the type 1 diabetes pancreas. Human pancreatic specimens were obtained from a unique cohort of individuals with recent onset or long standing type 1 diabetes. Density of parasympathetic axons was assessed by immunofluorescence and morphometry. Our main finding was a reduced density of parasympathetic axons in the exocrine, but not endocrine compartment of the pancreas in individuals with recent onset type 1 diabetes. The reduced density of parasympathetic axons in the exocrine compartment could have functional implications, e.g. be related to the exocrine insufficiency reported in type 1 diabetes patients. Further studies are needed to understand whether reduced parasympathetic innervation is a cause or consequence of type 1 diabetes.
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Laloyaux, Julien; Van der Linden, Martial; Levaux, Marie-Noëlle; Mourad, Haitham; Pirri, Anthony; Bertrand, Hervé; Domken, Marc-André; Adam, Stéphane; Larøi, Frank
2014-07-30
Difficulties in everyday life activities are core features of persons diagnosed with schizophrenia and in particular during multitasking activities. However, at present, patients׳ multitasking capacities have not been adequately examined in the literature due to the absence of suitable assessment strategies. We thus recently developed a computerized real-life activity task designed to take into account the complex and multitasking nature of certain everyday life activities where participants are required to prepare a room for a meeting. Twenty-one individuals diagnosed with schizophrenia and 20 matched healthy controls completed the computerized task. Patients were also evaluated with a cognitive battery, measures of symptomatology and real world functioning. To examine the ecological validity, 14 other patients were recruited and were given the computerized version and a real version of the meeting preparation task. Results showed that performance on the computerized task was significantly correlated with executive functioning, pointing to the major implication of these cognitive processes in multitasking situations. Performance on the computerized task also significantly predicted up to 50% of real world functioning. Moreover, the computerized task demonstrated good ecological validity. These findings suggest the importance of evaluating multitasking capacities in patients diagnosed with schizophrenia in order to predict real world functioning. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
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Tsujimura, Naoto; Takemoto, Hiroyoshi; Nakahara, Yujiro; Wakasugi, Masaki; Matsumoto, Takashi; Nishioka, Kiyonori; Takachi, Kou; Oshima, Satoshi; Yoshida, Kyotaro
2018-01-01
Actinomycosis is a chronic suppurative granulomatous disease caused by Actinomyces israelii. Preoperative confirmed diagnosis is very difficult, so most cases are diagnosed preoperatively as malignant tumors. We report a case of intraabdominal actinomycosis which was difficult to diagnose preoperatively. A woman, 60 years old, experienced discomfort in her lower right abdomen. She complained of nausea and anorexia and visited our hospital. Laboratory blood tests, abdominal CT, and abdominal MRI led to a diagnosis of a uterine sarcoma or primary intestinal mass, and she underwent surgery. Her histopathological diagnosis was intraabdominal actinomycosis. Actinomycosis is a chronic purulent granulomatous inflammation caused by Actinomyces israelii. No clinical symptoms or laboratory findings are characteristic of abdominal actinomycosis, so this disorder is very difficult to diagnose preoperatively. Therefore, many cases are diagnosed as malignant tumors and undergo surgery. After surgery, long-term antibiotic treatment (penicillin) is usually administered. We reported a case of intraabdominal actinomycosis that resulted in a difficult to diagnose intraperitoneal mass. When a large intraperitoneal mass is found, actinomycosis needs to be included as one of differential diagnoses. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Clinical heterogeneity in newly diagnosed Parkinson's disease
Post, Bart; Speelman, Johannes D.; de Haan, Rob J.
2008-01-01
OBJECTIVE: To determine clinical heterogeneity in newly diagnosed Parkinson's disease using cluster analysis and to describe the subgroups in terms of impairment, disability, perceived quality of life, and use of dopaminergic therapy. METHODS: We conducted a k-means cluster analysis in a prospective
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available ... diagnosed with cancer. You may be focused on cancer treatment and your child’s immediate health. You may feel ... points can help start the conversation: Cancer and cancer treatment may affect my child’s fertility. Will my child’s ...
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Diagnosing Febrile Illness in a Returned Traveler
Centers for Disease Control (CDC) Podcasts
2012-03-01
This podcast will assist health care providers in diagnosing febrile illness in patients returning from a tropical or developing country. Created: 3/1/2012 by National Center for Enteric, Zoonotic, and Infectious Diseases (NCEZID). Date Released: 3/1/2012.
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Ethical issues when involving people newly diagnosed with dementia in research.
Holland, Suzanne; Kydd, Angela
2015-03-01
To discuss the methodological and ethical review challenges encountered by researchers who want to enable people with dementia to be involved in research. There has been increasing recognition of the importance of involving people with dementia in research. However, an argument has centred on the protection of these vulnerable clients versus their freedom to be involved as participants in research. People with dementia do have the right to have their experiences explored. Involving this client group in research is essential to gain a true understanding of their needs. The lead author's experience of conducting a study in which people newly diagnosed with dementia were recruited as research participants. An interpretive phenomenological approach was adopted during this qualitative study, with data collected by means of one to one interviews with people newly diagnosed with dementia. This study was completed within the set timeframe, but a large part of the work was spent gaining ethical approval. This meant that the timeframe of the study period was reduced and as a result, it was only possible to recruit three participants. However, people with dementia are perhaps one of the most vulnerable client groups and it is only right that they should not be subjected to harm. Ethical review is an important part of research. Meeting the ethical requirements of research involving people with dementia requires time and careful preparation to ensure that researchers safeguard the interests of this vulnerable client group, while also allowing the participants the opportunity to exercise their autonomy to their fullest potential. Conducting research that involves people with dementia may be time consuming, but it is only fair that this client group are afforded the freedom to be involved in research. This small time-limited study points to the need for larger pilot studies to hear from individuals what needs they have following a diagnosis of dementia.
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Attention Deficit Hyperactivity Disorder Erroneously Diagnosed and Treated as Bipolar Disorder
Atmaca, Murad; Ozler, Sinan; Topuz, Mehtap; Goldstein, Sam
2009-01-01
Objective: There is a dearth of literature on patients erroneously diagnosed and treated for bipolar disorder. Method: The authors report a case of an adult with attention deficit hyperactivity disorder erroneously diagnosed and treated for bipolar disorder for 6 years. At that point, methylphenidate was initiated. The patient was judged to be a…
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DEFF Research Database (Denmark)
Tvermosegaard, Maria; Ronn, Pernille Falberg; Pedersen, Michael Lynge
2018-01-01
not previously been validated specifically. The objective of the study was to validate diagnoses of CVD in GHDR. The study was conducted as a validation study with primary investigator comparing information in GHDR with information in medical records. Diagnoses in GHDR were considered correct and thus valid......Cardiovascular disease (CVD) is one of the leading causes of death worldwide. In Greenland, valid estimates of prevalence and incidence of CVD do not exist and can only be calculated if diagnoses of CVD in the Greenlandic Hospital Discharge Register (GHDR) are correct. Diagnoses of CVD in GHDR have...... if they matched the diagnoses or the medical information in the medical records. A total of 432 online accessible medical records with a cardiovascular diagnosis according to GHDR from Queen Ingrid's Hospital from 2001 to 2013 (n=291) and from local health care centres from 2007 to 2013 (n=141) were reviewed...
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Crocker, Anne G; Nicholls, Tonia L; Seto, Michael C; Charette, Yanick; Côté, Gilles; Caulet, Malijai
2015-01-01
Objective: To examine the psychosocio-criminological characteristics of not criminally responsible on account of mental disorder (NCRMD)–accused people and compare them across the 3 most populous provinces. In Canada, the number of people found NCRMD has risen during the past 20 years. The Criminal Code is federally legislated but provincially administered, and mental health services are provincially governed. Our study offers a rare opportunity to observe the characteristics and trajectories of NCRMD–accused people. Method: The National Trajectory Project examined 1800 men and women found NCRMD in British Columbia (n = 222), Quebec (n = 1094), and Ontario (n = 484) between May 2000 to April 2005, followed until December 2008. Results: The most common primary diagnosis was a psychotic spectrum disorder. One-third of NCRMD–accused people had a severe mental illness and a concomitant substance use disorder, with British Columbia having the highest rate of dually diagnosed NCRMD–accused people. Most accused people (72.4%) had at least 1 prior psychiatric hospitalization. Two-thirds of index NCRMD offences were against the person, with a wide range of severity. Family members, followed by professionals, such as police and mental health care workers, were the most frequent victims. Quebec had the highest proportion of people with a mood disorder and the lowest median offence severity. There were both interprovincial differences and similarities in the characteristics of NCRMD–accused people. Conclusions: Contrary to public perception, severe violent offenses such as murder, attempted murder or sexual offences represent a small proportion of all NCRMD verdict offences. The results reveal a heterogeneous population regarding mental health and criminological characteristics in need of hierarchically organized forensic mental health services and levels of security. NCRMD–accused people were well known to civil psychiatric services prior to being found NCRMD
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Wilroy, Jereme; Knowlden, Adam
2016-01-01
Background: Approximately 200,000 individuals have a spinal cord injury (SCI) and more than 12,000 new cases are diagnosed each year in the United States. Lowered physical functioning caused by SCI often leads to a sedentary lifestyle, increasing risk for chronic diseases, secondary medical conditions, and lower quality of life. Purpose: The aim…
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Griffin, Simon J; Simmons, Rebecca K; Prevost, A Toby; Williams, Kate M; Hardeman, Wendy; Sutton, Stephen; Brage, Søren; Ekelund, Ulf; Parker, Richard A; Wareham, Nicholas J; Kinmonth, Ann Louise
2014-07-01
The aim of this study was to assess whether or not a theory-based behaviour change intervention delivered by trained and quality-assured lifestyle facilitators can achieve and maintain improvements in physical activity, dietary change, medication adherence and smoking cessation in people with recently diagnosed type 2 diabetes. An explanatory randomised controlled trial was conducted in 34 general practices in Eastern England (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care-Plus [ADDITION-Plus]). In all, 478 patients meeting eligibility criteria (age 40 to 69 years with recently diagnosed screen or clinically detected diabetes) were individually randomised to receive either intensive treatment (n = 239) or intensive treatment plus a theory-based behaviour change intervention led by a facilitator external to the general practice team (n = 239). Randomisation was central and independent using a partial minimisation procedure to balance stratifiers between treatment arms. Facilitators taught patients skills to facilitate change in and maintenance of key health behaviours, including goal setting, self-monitoring and building habits. Primary outcomes included physical activity energy expenditure (individually calibrated heart rate monitoring and movement sensing), change in objectively measured fruit and vegetable intake (plasma vitamin C), medication adherence (plasma drug levels) and smoking status (plasma cotinine levels) at 1 year. Measurements, data entry and laboratory analysis were conducted with staff unaware of participants' study group allocation. Of 475 participants still alive, 444 (93%; intervention group 95%, comparison group 92%) attended 1-year follow-up. There were no significant differences between groups in physical activity (difference: +1.50 kJ kg(-1) day(-1); 95% CI -1.74, 4.74), plasma vitamin C (difference: -3.84 μmol/l; 95% CI -8.07, 0.38), smoking (OR 1.37; 95% CI 0.77, 2.43) and
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Fundus fluorescence Angiography in diagnosing diabetic retinopathy.
Wang, Shuhui; Zuo, Yuqin; Wang, Ning; Tong, Bin
2017-01-01
To investigate the manifestation characteristics of fundus fluorescence angiography (FFA) and its values in diagnosing diabetic retinopathy through comparing direct ophthalmoscopy. Two hundred fifty patients (500 eyes) who were suspected as diabetic retinopathy and admitted to the hospital between February 2015 and December 2016 were selected. They underwent direct ophthalmoscopy and FFA. The manifestation characteristics of FFA in the diagnosis of diabetic retinopathy were summarized. The two examination methods were compared. In the diagnosis with direct ophthalmoscopy, 375 eyes out of 500 eyes were diagnosed as diabetic retinopathy (75%); there were 74 eyes at stage I, 88 eyes at stage II, 92 eyes at stage III, 83 eyes of stage IV, 28 eyes of stage V and 10 eyes of stage VI. In the diagnosis with FFA, 465 eyes out of 500 eyes were diagnosed as diabetic retinopathy (93%); there were 94 eyes at stage I, 110 eyes at stage II, 112 at stage III, 92 eyes at stage IV, 41 eyes at stage V and 16 eyes at stage VI. The detection rate of diabetic retinopathy using FFA was significantly higher than that using direct ophthalmoscopy (Pretinopathy (67.96%), 75 eyes had pre-proliferative lesions (16.13%), 149 eyes had proliferative lesions (32.04%), 135 eyes had diabetic maculopathy (29.03%) and 31 eyes had diabetic optic disc lesions (6.67%). The detection rate of diabetic retinopathy using FFA is higher than that using direct ophthalmoscopy. FFA could accurately determine clinical stage. Therefore, it is an important approach in treatment efficacy evaluation and treatment guidance, suggesting a significant application value.
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An Event-based Approach to Hybrid Systems Diagnosability
National Aeronautics and Space Administration — Diagnosability is an important issue in the design of diagnostic systems, because it helps identify whether sufficient information is available to distinguish all...
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Susceptibility, likelihood to be diagnosed, worry and fear for contracting Lyme disease.
Fogel, Joshua; Chawla, Gurasees S
Risk perception and psychological concerns are relevant for understanding how people view Lyme disease. This study investigates the four separate outcomes of susceptibility, likelihood to be diagnosed, worry, and fear for contracting Lyme disease. University students (n=713) were surveyed about demographics, perceived health, Lyme disease knowledge, Lyme disease preventive behaviors, Lyme disease history, and Lyme disease miscellaneous variables. We found that women were associated with increased susceptibility and fear. Asian/Asian-American race/ethnicity was associated with increased worry and fear. Perceived good health was associated with increased likelihood to be diagnosed, worry, and fear. Correct knowledge was associated with increased susceptibility and likelihood to be diagnosed. Those who typically spend a lot of time outdoors were associated with increased susceptibility, likelihood to be diagnosed, worry, and fear. In conclusion, healthcare providers and public health campaigns should address susceptibility, likelihood to be diagnosed, worry, and fear about Lyme disease, and should particularly target women and Asians/Asian-Americans to address any possible misconceptions and/or offer effective coping strategies. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.
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Construction and validation of nursing diagnoses for people in palliative care
Directory of Open Access Journals (Sweden)
Rudval Souza da Silva
Full Text Available ABSTRACT Objective: to construct and validate nursing diagnoses for people in palliative care based on the Dignity-Conserving Care Model and the International Classification for Nursing Practice. Method: a two-stage methodological study: 1 construction of the database of clinically and culturally relevant terms for the nursing care for people in palliative care and 2 construction of nursing diagnoses from the database of terms, based on the guidelines of the International Council of Nurses. Results: the 262 terms validated constituted a database of terms from which 56 nursing diagnoses were developed. Of these, 33 were validated by a group of 26 experts, and classified in the three categories of the Dignity-Conserving Care Model: illness-related concerns (21; dignity-conserving repertoire (9; and social dignity inventory (3. Conclusion: of the 33 validated diagnoses, 18 of them could be included in the update of the Catalog of the International Classification for Nursing Practice - palliative care for a dignified death. The study contributes to support the clinical reasoning and decision making of the nurse.
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Fertility Preservation for Children Diagnosed with Cancer
Full Text Available Sorry, you need to enable JavaScript to visit this website. Skip to main content SaveMyFertility An Online Fertility Preservation Toolkit for ... for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult survivors of childhood cancer ...
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Siblings of people diagnosed with a mental disorder and posttraumatic growth.
Sanders, Avihay; Szymanski, Kate
2013-10-01
This study examines the potential for posttraumatic growth (PTG) for siblings of persons diagnosed with a mental disorder. Using the posttraumatic growth Inventory we compared siblings (N = 33) with a comparison group of participants who did not experience trauma (N = 30). Our group of participants who had a sibling diagnosed with a mental disorder by a mental health professional (N = 33) reported higher PTG scores with mostly large effect sizes on most of the inventory subscales. Participants who took an active role in care giving experienced less PTG than participants who did not. Having a sibling diagnosed with a mental disorder presents an opportunity to experience PTG. Implications for the therapeutic milieus are discussed.
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Nursing diagnoses in children with congenital heart disease: a survival analysis.
Martins da Silva, Viviane; Lopes, Marcos Venícios de Oliveira; Leite de Araujo, Thelma
2007-01-01
To analyze the relationship between nursing diagnoses and survival rates in children with congenital heart disease. A total of 270 observations were carried out in 45 children with congenital heart disease who were followed for 15 days. Differences in mean survival times were identified in children not more than 4 months of age with respect to the following diagnoses: impaired gas exchange, ineffective breathing pattern, activity intolerance, delayed growth and development, and decreased cardiac output. The main diagnoses are identified early in the hospitalization period and are conditions resulting from hemodynamic alterations and prescribed medical treatment. Congenital heart disease provokes serious hemodynamic alterations that generate human responses, which should be treated proactively.
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Ciliates learn to diagnose and correct classical error syndromes in mating strategies.
Clark, Kevin B
2013-01-01
Preconjugal ciliates learn classical repetition error-correction codes to safeguard mating messages and replies from corruption by "rivals" and local ambient noise. Because individual cells behave as memory channels with Szilárd engine attributes, these coding schemes also might be used to limit, diagnose, and correct mating-signal errors due to noisy intracellular information processing. The present study, therefore, assessed whether heterotrich ciliates effect fault-tolerant signal planning and execution by modifying engine performance, and consequently entropy content of codes, during mock cell-cell communication. Socially meaningful serial vibrations emitted from an ambiguous artificial source initiated ciliate behavioral signaling performances known to advertise mating fitness with varying courtship strategies. Microbes, employing calcium-dependent Hebbian-like decision making, learned to diagnose then correct error syndromes by recursively matching Boltzmann entropies between signal planning and execution stages via "power" or "refrigeration" cycles. All eight serial contraction and reversal strategies incurred errors in entropy magnitude by the execution stage of processing. Absolute errors, however, subtended expected threshold values for single bit-flip errors in three-bit replies, indicating coding schemes protected information content throughout signal production. Ciliate preparedness for vibrations selectively and significantly affected the magnitude and valence of Szilárd engine performance during modal and non-modal strategy corrective cycles. But entropy fidelity for all replies mainly improved across learning trials as refinements in engine efficiency. Fidelity neared maximum levels for only modal signals coded in resilient three-bit repetition error-correction sequences. Together, these findings demonstrate microbes can elevate survival/reproductive success by learning to implement classical fault-tolerant information processing in social
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Ciliates learn to diagnose and correct classical error syndromes in mating strategies
Directory of Open Access Journals (Sweden)
Kevin Bradley Clark
2013-08-01
Full Text Available Preconjugal ciliates learn classical repetition error-correction codes to safeguard mating messages and replies from corruption by rivals and local ambient noise. Because individual cells behave as memory channels with Szilárd engine attributes, these coding schemes also might be used to limit, diagnose, and correct mating-signal errors due to noisy intracellular information processing. The present study, therefore, assessed whether heterotrich ciliates effect fault-tolerant signal planning and execution by modifying engine performance, and consequently entropy content of codes, during mock cell-cell communication. Socially meaningful serial vibrations emitted from an ambiguous artificial source initiated ciliate behavioral signaling performances known to advertise mating fitness with varying courtship strategies. Microbes, employing calcium-dependent Hebbian-like decision making, learned to diagnose then correct error syndromes by recursively matching Boltzmann entropies between signal planning and execution stages via power or refrigeration cycles. All eight serial contraction and reversal strategies incurred errors in entropy magnitude by the execution stage of processing. Absolute errors, however, subtended expected threshold values for single bit-flip errors in three-bit replies, indicating coding schemes protected information content throughout signal production. Ciliate preparedness for vibrations selectively and significantly affected the magnitude and valence of Szilárd engine performance during modal and nonmodal strategy corrective cycles. But entropy fidelity for all replies mainly improved across learning trials as refinements in engine efficiency. Fidelity neared maximum levels for only modal signals coded in resilient three-bit repetition error-correction sequences. Together, these findings demonstrate microbes can elevate survival/reproductive success by learning to implement classical fault-tolerant information processing in
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Directory of Open Access Journals (Sweden)
Christopher Harrison
Full Text Available To estimate the prevalence of common chronic conditions and multimorbidity among patients at GP encounters and among people in the Australian population. To assess the extent to which use of each individual patient's GP attendance over the previous year, instead of the average for their age-sex group, affects the precision of national population prevalence estimates of diagnosed chronic conditions.A sub-study (between November 2012 and March 2016 of the Bettering the Evaluation and Care of Health program, a continuous national study of GP activity. Each of 1,449 GPs provided data for about 30 consecutive patients (total 43,501 indicating for each, number of GP attendances in previous year and all diagnosed chronic conditions, using their knowledge of the patient, patient self-report, and patient's health record.Hypertension (26.5% was the most prevalent diagnosed chronic condition among patients surveyed, followed by osteoarthritis (22.7%, hyperlipidaemia (16.6%, depression (16.3%, anxiety (11.9%, gastroesophageal reflux disease (GORD (11.3%, chronic back pain (9.7% and Type 2 diabetes (9.6%. After adjustment, we estimated population prevalence of hypertension as 12.4%, 9.5% osteoarthritis, 8.2% hyperlipidaemia, 8.0% depression, 5.8% anxiety and 5.2% asthma. Estimates were significantly lower than those derived using the previous method. About half (51.6% the patients at GP encounters had two or more diagnosed chronic conditions and over one third (37.4% had three or more. Population estimates were: 25.7% had two or more diagnosed chronic conditions and 15.8% had three or more.Of the three approaches we have tested to date, this study provides the most accurate method for estimation of population prevalence of chronic conditions using the GP as an expert interviewer, by adjusting for each patient's reported attendance.
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Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report
International Nuclear Information System (INIS)
Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang
2009-01-01
Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia
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Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report
Energy Technology Data Exchange (ETDEWEB)
Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang [Gachon University of Medicine and Science, Incheon (Korea, Republic of)
2009-12-15
Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia
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Weinrich, Julius Matthias; Bannas, Peter; Regier, Marc; Keller, Sarah; Kluth, Luis; Adam, Gerhard; Henes, Frank Oliver
2018-03-01
The purpose of this study is to assess the diagnostic yield of low-dose (LD) CT for alternative diagnoses in patients with suspected urolithiasis. In this retrospective study, we included 776 consecutive patients who underwent unenhanced abdominal CT for evaluation of suspected urolithiasis. All examinations were performed with an LD CT protocol; images were reconstructed using iterative reconstruction. The leading LD CT diagnosis was recorded for each patient and compared with the final clinical diagnosis, which served as the reference standard. The mean (± SD) effective dose of CT was 1.9 ± 0.6 mSv. The frequency of urolithiasis was 82.5% (640/776). LD CT reached a sensitivity of 94.1% (602/640), a specificity of 100.0% (136/136), and an accuracy of 95.1% (738/776) for the detection of urolithiasis. In 93 of 136 patients (68.4%) without urolithiasis, alternative diagnoses were established as the final clinical diagnoses. Alternative diagnoses were most commonly located in the genitourinary (n = 53) and gastrointestinal (n = 18) tracts. LD CT correctly provided alternative diagnoses for 57 patients (61.3%) and was false-negative for five patients (5.4%). The most common clinical alternative diagnoses were urinary tract infections (n = 22). Seven diagnoses missed at LD CT were located outside the FOV. For 43 of all 776 patients (5.5%), neither LD CT nor clinical workup could establish a final diagnosis. The sensitivity, specificity, and accuracy of LD CT for the detection of alternative diagnoses were 91.9% (57/62), 95.6% (43/45), and 93.5% (100/107), respectively. LD CT enables the diagnosis of most alternative diagnoses in the setting of suspected urolithiasis. The most frequent alternative diagnoses missed by LD CT are urinary tract infections or diagnoses located outside the FOV of the abdominopelvic CT scan.
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Czyzyk, Adam; Filipowicz, Dorota; Podfigurna, Agnieszka; Ptas, Paula; Piestrzynska, Malgorzata; Smolarczyk, Roman; Genazzani, Andrea R; Meczekalski, Blazej
2017-05-01
Premature ovarian insufficiency (POI) is defined as a cessation of function of ovaries in women younger than 40 years old. Brain-derived neurotrophic factor (BDNF) is a protein critically involved in neuronal growth and metabolism. BDNF also has been shown to be important regulator of oocyte maturation. Recent data show that BDNF can be potentially involved in POI pathology. The aim of the study was to assess the BDNF plasma concentrations in patients diagnosed with idiopathic POI. 23 women diagnosed with POI (age 31 ± 7 years) and 18 (age 31 ± 3) controls were included to the study, matched according to age and body mass index. The BDNF concentrations were measured using competitive enzyme-linked immunosorbent assay (ELISA). Hormonal and metabolic parameters were measured in all individuals, in controls in late follicular phase. The POI group demonstrated lower mean plasma concentrations of BDNF (429.25 ± 65.52 pg/ml) in comparison to healthy controls (479.75 ± 34.75 pg/ml, p = 0.0345). The BDNF plasma concentration correlated negatively (R = -0.79, p BDNF and progesterone in controls. In conclusion, POI patients show significantly lower BDNF plasma concentration and it correlates with the duration of amenorrhea. This observation brings important potential insights to the pathology of POI.
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High prevalence of tuberculosis diagnosed during autopsy ...
African Journals Online (AJOL)
The primary aims of tuberculosis (TB) control programmes is early diagnosis and prompt treatment of infectious cases to limit transmission. Failure to diagnose and adequately treat TB could lead to premature death and unrecognized transmission of Mycobacterium tuberculosis. The proportion of missed TB cases has not ...
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Chest Radiographic Findings in Newly Diagnosed Pulmonary ...
African Journals Online (AJOL)
Five hundred newly diagnosed cases of Pulmonary Tuberculosis were treated with directly observed short-course treatment and 100 of them had chest radiographic examination done. The various chest radiographic patterns in the 100 subjects were studied and included: Fluffy exudative changes 80(80%), fibrosis 70(70%) ...
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Remembering and diagnosing clients: Does experience matter?
Witteman, C.L.M.; Tollenaar, M.S.
2012-01-01
Experienced mental health clinicians often do not outperform novices in diagnostic decision making. In this paper we look for an explanation of this phenomenon by testing differences in memory processes. In two studies we aimed to look at differences in accuracy of diagnoses in relation to free
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A pancreatic neuroendocrine tumor diagnosed during the ...
African Journals Online (AJOL)
Pancreatic neuroendocrine tumors (PNET) are increasingly being discovered. A case of PNET diagnosed and treated during the management of acute appendicitis is presented and discussed. The importance of imaging modalities in patients with acute abdominal pain is emphasized. To the best our knowledge, this is the ...
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Accuracy of Veterans Affairs Databases for Diagnoses of Chronic Diseases
Singh, Jasvinder A.
2009-01-01
Introduction Epidemiologic studies usually use database diagnoses or patient self-report to identify disease cohorts, but no previous research has examined the extent to which self-report of chronic disease agrees with database diagnoses in a Veterans Affairs (VA) health care setting. Methods All veterans who had a medical care visit from October 1, 1996, through May 31, 1998, at any of the Veterans Integrated Service Network 13 facilities were surveyed about physician diagnosis of chronic ob...
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Maekawa, Koichi; Naka, Megumi; Shuto, Saki; Harada, Yuka; Ikegami, Yumiko
2017-09-01
The utility of bronchoscopy for the diagnosis of pulmonary Mycobacterium avium-intracellulare complex (MAC) disease has been reported; however, which patients require bronchoscopy remains unclear. Our objective was to identify the characteristics of the patients in whom bronchoscopy is needed for the diagnosis of MAC disease. Fifty-four patients with pulmonary MAC disease were divided into two groups according to established diagnostic criteria: 39 patients were diagnosed by sputum culture and 15 patients were diagnosed by bronchial lavage culture. We analysed the differences in demographic and clinical characteristics as well as microbiological and radiological data between the two groups. There were no significant differences in age, sex, smoking status, MAC species, underlying diseases, or steroid use. Significantly more patients diagnosed by sputum culture than bronchial lavage culture had a positive sputum smear for acid-fast bacilli (79.5% vs. 0.0%, respectively; p disease, bronchiectasis, and cavities. However, more patients diagnosed by sputum culture than bronchial lavage culture had abnormalities in the left upper division (48.7% vs. 13.3%, respectively; p = 0.017) and higher numbers of affected lobes (4.3 ± 1.4 vs. 3.3 ± 1.6, respectively; p = 0.034). If patients suspected of having pulmonary MAC disease have a negative sputum smear, no symptoms, no abnormal findings in the left upper division, or fewer affected lobes on computed tomography, bronchoscopy might be needed for the diagnosis. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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Directory of Open Access Journals (Sweden)
Marcus Lundberg
Full Text Available To elucidate the etiology of type 1 diabetes, the affected pancreas needs to be thoroughly characterized. Pancreatic innervation has been suggested to be involved in the pathology of the disease and a reduction of sympathetic innervation of the islets was recently reported. In the present study, we hypothesized that parasympathetic innervation would be altered in the type 1 diabetes pancreas. Human pancreatic specimens were obtained from a unique cohort of individuals with recent onset or long standing type 1 diabetes. Density of parasympathetic axons was assessed by immunofluorescence and morphometry. Our main finding was a reduced density of parasympathetic axons in the exocrine, but not endocrine compartment of the pancreas in individuals with recent onset type 1 diabetes. The reduced density of parasympathetic axons in the exocrine compartment could have functional implications, e.g. be related to the exocrine insufficiency reported in type 1 diabetes patients. Further studies are needed to understand whether reduced parasympathetic innervation is a cause or consequence of type 1 diabetes.
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Diagnosing Allergic Contact Dermatitis Through Elimination, Perception, Detection and Deduction.
Pongpairoj, Korbkarn; Puangpet, Pailin; Thaiwat, Supitchaya; McFadden, John P
2017-10-01
Several authors have commented upon the skills of detection required in making a diagnosis of allergic contact dermatitis. Here, we emphasise the search for clues in a systematic manner. We describe four stages as part of a systematic method for diagnosing allergic contact dermatitis. Firstly, elimination (or inclusion) of non-allergic diagnoses. Secondly, perception: the pre-patch test diagnosis and the 'three scenarios' principle. Thirdly, detection: optimising the sensitivity of the patch test process. Fourthly, deduction: diagnosing allergic contact dermatitis by associating the dermatitis with the allergen exposure. We further compare and contrast the pre-patch test history and examination with the markedly different one ('microhistory' and 'microexamination') used after patch testing. The importance of knowledge of contact dermatitis literature is emphasised with a review of recent publications. Finally, we also highlight the use of contact allergy profiling as an investigative tool in the diagnosis of allergic contact dermatitis.
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Liu, Danyang; Gan, Rongchang; Zhang, Weidi; Wang, Wei; Saiyin, Hexige; Zeng, Wenjiao; Liu, Guoyuan
2018-01-01
Emergency medicine is a 'high risk' specialty. Some diseases develop suddenly and progress rapidly, and sudden unexpected deaths in the emergency department (ED) may cause medical disputes. We aimed to assess discrepancies between antemortem clinical diagnoses and postmortem autopsy findings concerning emergency medicine dispute cases and to figure out the most common major missed diagnoses. Clinical files and autopsy reports were retrospectively analysed and interpreted. Discrepancies between clinical diagnoses and autopsy diagnoses were evaluated using modified Goldman classification as major and minor discrepancy. The difference between diagnosis groups was compared with Pearson χ 2 test. Of the 117 cases included in this study, 71 of cases (58 class I and 13 class II diagnostic errors) were revealed as major discrepancies (60.7%). The most common major diagnoses were cardiovascular diseases (54 cases), followed by pulmonary diseases, infectious diseases and so on. The difference of major discrepancy between the diagnoses groups was significant (ppay special attention to in practice. This study reaffirmed the necessity and usefulness of autopsy in auditing death in EDs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Incidence of retinal complications in a cohort of newly diagnosed diabetic patients.
Directory of Open Access Journals (Sweden)
Elisa Martín-Merino
Full Text Available PURPOSE: We aimed at estimating the incidence of diabetic retinopathy (DR and maculopathy (DMP among newly diagnosed type 1 (t1DM and type 2 diabetic patients (t2DM in the United Kingdom primary care system. The incidence of DMP among patients with DR was also estimated. METHOD: We conducted a cohort study using The Health Improvement Network database. The cohort included 64,983 incident diabetic patients (97.3% were t2DM aged 1-84 years diagnosed between 2000 and 2007. This cohort was followed from the date of diabetes diagnosis until recording of DR or DMP in two separate follow-ups. Follow-up was censored at 85 years of age, death, or end of 2008. An additional follow-up was conducted from DR to DMP diagnosis using similar censoring reasons. DR and DMP cumulative incidences were calculated as well as incidence rates (IR; cases per 1,000 person-years per calendar period (2000-2001 and 2006-2007. RESULTS: Follow-up for DR: 9 years after diabetes diagnosis, 28% of t2DM and 24% of t1DM patients had developed DR (7,899 incident DR cases. During the first 2 years with diabetes, the IR was almost 2 times higher in patients diagnosed with diabetes in 2006-2007 (47.7 than among those diagnosed in 2000-2001 (24.5. Follow-up for DMP: 9 years after diabetes diagnosis, 3.6% of t2DM and 4.4% of t2DM patients had developed DMP (912 incident DMP cases. During the first 2 years with diabetes, the IR was three times higher in patients diagnosed with diabetes in 2006-2007 (5.8 than among those diagnosed in 2000-2001 (1.8. Macular oedema occurred in 0.8% of patients. CONCLUSIONS: In a cohort of incident diabetes, 28% of patients developed retinopathy and 4% maculopathy within the first 9 years. The 2-year IRs of DR and DMP were higher in patients diagnosed with diabetes during the period 2006-2007 than in those diagnosed during the 2000-2001 period.
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Directory of Open Access Journals (Sweden)
Silvana Pereira de Souza
2014-01-01
Full Text Available Paracoccidioidomycosis (PCM is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis and is endemic to Brazil. The aim of this study was to perform a retrospective analysis of the PCM cases in the countryside south of Rio Grande do Sul, Brazil. The files from four histopathology laboratories located in the city of Pelotas were obtained, and all of the epidemiological and clinical data from the PCM diagnosed cases were collected for analysis. A total of 123 PCM cases diagnosed between 1966 and 2009 were selected. Of these patients, 104 (84.5% were male, and 17 were female. The patients ranged from 02 to 92 years of age. Fifty-two cases (41.9% were obtained from the oral pathology laboratory, and the remaining 71 cases (58.1% were obtained from the three general pathology laboratories. Of all of the patients studied, 65.2% lived in rural zones and worked in agriculture or other related fields. Data on the evolution of this disease was available for 43 cases, and the time frame ranged from 20 to 2920 days (mean = 572.3 days. An accurate diagnosis performed in less than 30 days only occurred in 21% of the cases. PCM is endemic to the countryside of Rio Grande do Sul. Therefore, it is recommended that PCM be included as a differential diagnosis, mainly for individuals between 30 and 60 years of age, living in rural zones and who have respiratory signs and associated-oropharyngeal lesions.
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Individualizing Services, Individualizing Responsibility
DEFF Research Database (Denmark)
Garsten, Christina; Hollertz, Katarina; Jacobsson, Kerstin
possibilities for individual voice, autonomy and self-determination in the local delivery of activation policy? What barriers do specific organisational models and practices imply for clients to choose, determine and access tailor-made programmes and services? What policy technologies are at work in governing......-oriented, and the normative demands placed on individuals appear increasingly totalizing, concerning the whole individual rather than the job-related aspects only. The paper is based on 23 in-depth interviews with individual clients as well as individual caseworkers and other professionals engaged in client-related work...
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The challenge of diagnosing seborrheic keratosis by reflectance confocal microscopy.
Guo, A; Chen, J; Yang, C; Ding, Y; Zeng, Q; Tan, L
2018-05-24
Seborrheic keratosis (SK) is one of the most common skin tumors seen by dermatologists. It should be differentiated with many diseases, especially skin tumors. Reflectance confocal microscopy (RCM) has been applied for evaluation of SK. There are a few studies that describe the RCM of SK. The aim of the study was to find the challenge of diagnosing seborrheic keratosis by reflectance confocal microscopy. A total of 390 patients with a clinical suspicious diagnosis of seborrheic keratosis were enrolled in this study, and lesions from each patient were imaged with RCM. Thirty-seven of these patients performed a biopsy in order to be given a histological diagnosis. We retrospectively analyzed the outcomes of RCM diagnosis and histological diagnosis, and then found the RCM characteristics of biopsy-proven lesions. According to RCM images, 258 of 390 (66.2%) patients were diagnosed with SK, 97 of 390 (24.9%) patients could not be diagnosed by the dermatologist according to RCM. Of all 37 biopsied lesions, 23 were SK, 6 were actinic keratosis, 2 were basal cell carcinoma, and 2 were squamous cell carcinoma. It is challenge to diagnose seborrheic keratosis by reflectance confocal microscopy. It may due to the variable clinical and RCM appearances of SK, and limited depth of RCM. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Diagnosing smallpox: would you know it if you saw it?
Woods, Ryan; McCarthy, Tara; Barry, M Anita; Mahon, Barbara
2004-01-01
The intentional release of anthrax in the United States in 2001 and other recent acts of terrorism have highlighted the possibility of intentional release of smallpox by terrorists. Little is known about physicians' ability to diagnose smallpox, especially in the critical first days, when the potential for rapid control of transmission is greatest. During December 2002 and January 2003, primary care and emergency physicians at a large urban academic medical center were surveyed regarding the diagnosis and management of patients who present with vesicular rash illness. In addition to demographic and training-related questions, the questionnaire included items about perceived comfort in diagnosing and evaluating rashes, knowledge of the key differential diagnostic characteristics of chickenpox and smallpox, and the diagnostic interpretation of color photographs of patients with smallpox or chickenpox. Responses were summarized as a perceived comfort score, a differential diagnosis score, and a picture score. Of 266 eligible physicians, 178 (67%) responded. Of these, 95% thought clinicians need more education about bioterrorism; only 17% reported comfort in diagnosing smallpox. Although most physicians recognized pictures of smallpox and chickenpox, only 36% correctly answered 3 of 4 questions regarding differential diagnosis, an important aspect of identifying cases early. Those who were comfortable diagnosing rash illnesses had higher differential diagnosis scores. Strategies for bioterrorism-related training could take advantage of physicians' awareness of their own knowledge deficits.
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The Amyand's Hernia: A Rare Clinical Entity Diagnosed by Computed Tomography.
Keskin, Suat; Simşek, Cihan; Keskin, Zeynep
2013-01-01
Amyand's hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Amyand's hernia is an extremely rare condition and is often misdiagnosed. Traditionally, these hernias have been diagnosed at surgery but are increasingly diagnosed by abdominal computed tomography (CT) scans. CT of the abdomen may help in guiding the diagnosis.
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A Trial to Maximize the Accuracy of Military Womens Genitourinary Self-Diagnoses
2013-04-08
diagnoses and providers’ (N=5) clinical diagnoses to DNA-probe analysis for evidence of Gardnerella species, Trichomonas vaginalis , and Candida species in...vaginal itching, to differentiate between bacterial/ Trichomonas , and yeast vaginitis.7 The research plan was to compare women’s (N=715) self
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International Nuclear Information System (INIS)
Fraim, N. L.
2006-01-01
A possible diagnosis of any form of cancer is every person's worst nightmare. Primarily among women, the most feared cancer diagnosis is breast cancer. With the development of modern technology, a variety of treatments are available; however, these treatments are not without side effects. Receiving the diagnosis initiates the development of psychological upheaval within the person. The modality and amount of treatment of treatment as well as the amount of social support the individual receives plays an important role in the person's survival throughout this disease. The purpose of this paper is to provide the reader with an overview of the psychological turmoil experienced by individual's diagnosed with breast cancer. Data for this paper was collected via electronic databases and internet sources
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Directory of Open Access Journals (Sweden)
Syed Rahman
Full Text Available BACKGROUND: Common mental disorders (CMD have become one of the leading causes for disability pension (DP. Studies on predictors of adverse health outcome following DP are sparse. This study aimed to examine the association of different socio-demographic factors and health care consumption with subsequent suicidal behaviour among individuals on DP due to CMD. METHOD: This is a population-based prospective cohort study based on register data. All individuals aged 18-64 years, living in Sweden on 31-Dec-2004 who in 2005 were on DP due to CMD (N = 46 745 were followed regarding suicide attempt and suicide (2006-10. Univariate and multivariate hazard ratios (HR and 95% confidence intervals (CI for suicidal behaviour were estimated by Cox regression. RESULTS: During the five-year follow-up, 1 046 (2.2% and 210 (0.4% individuals attempted and committed suicide, respectively. Multivariate analyses showed that young age (18-24 years and low education predicted suicide attempt, while living alone was associated with both higher suicide attempt and suicide (range of HRs 1.23 to 1.68. Combined prescription of antidepressants with anxiolytics during 2005 and inpatient care due to mental diagnoses or suicide attempt (2001-05 were strongly associated with suicide attempt and suicide (range of HRs 1.3 to 4.9, while inpatient care due to somatic diagnoses and specialized outpatient care due to mental diagnoses during 2001-05 only predicted suicide attempt (HR 1.45; 95% CI: 1.3-1.7; HR 1.30; 95% CI: 1.1-1.7. CONCLUSIONS: Along with socio-demographic factors, it is very important to consider type of previous healthcare use and medication history when designing further research or intervention aiming at individuals on DP due to CMD. Further research is warranted to investigate both characteristics of disability pension due to CMD, like duration, diagnoses and grade as well as mechanisms to subsequent suicidal behavior, taking potential gender differences into
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Kothari, Mohit; Spin-Neto, Rubens; Nielsen, Jørgen Feldbæk
2016-01-01
To perform a detailed clinical oral health assessment and oral-health-related social and behavioural aspect assessment in individuals with acquired brain injury (ABI). Prospective observational study. Thirteen individuals with ABI were recruited. Individual's social and behavioural history, bed-side oral examination score (BOE), tooth condition and periodontal status (bleeding, plaque and clinical attachment loss) were thoroughly examined. The entire examination took up to 60 minutes, using proper dental armamentarium. All evaluated individuals were diagnosed with chronic generalized periodontitis. A relationship between active periodontal disease and severe BOE score was observed (p = 0.01). Significant interaction between severe BOE scores (≥ 15 or ≥ 14) and periodontal disease severity of ≥ 2 mm (p = 0.01) was observed. The same interaction was seen between severe BOE scores and the combination of 75% extent and 2 mm severity (p = 0.01). Severity and activity of periodontitis showed dependence on individual brushing frequency (p = 0.03 and p = 0.05, respectively). Individuals with ABI had a poor status across a range of oral-, dental- and periodontal-related parameters. Further structured studies are required to define evidence-based assessment approaches for such clinical reality.
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Factors associated with abnormal spirometry among HIV-infected individuals.
Drummond, M Bradley; Huang, Laurence; Diaz, Philip T; Kirk, Gregory D; Kleerup, Eric C; Morris, Alison; Rom, William; Weiden, Michael D; Zhao, Enxu; Thompson, Bruce; Crothers, Kristina
2015-08-24
HIV-infected individuals are susceptible to development of chronic lung diseases, but little is known regarding the prevalence and risk factors associated with different spirometric abnormalities in this population. We sought to determine the prevalence, risk factors and performance characteristics of risk factors for spirometric abnormalities among HIV-infected individuals. Cross-sectional cohort study. We analyzed cross-sectional US data from the NHLBI-funded Lung-HIV consortium - a multicenter observational study of heterogeneous groups of HIV-infected participants in diverse geographic sites. Logistic regression analysis was performed to determine factors statistically significantly associated with spirometry patterns. A total of 908 HIV-infected individuals were included. The median age of the cohort was 50 years, 78% were men and 68% current smokers. An abnormal spirometry pattern was present in 37% of the cohort: 27% had obstructed and 10% had restricted spirometry patterns. Overall, age, smoking status and intensity, history of Pneumocystis infection, asthma diagnosis and presence of respiratory symptoms were independently associated with an abnormal spirometry pattern. Regardless of the presence of respiratory symptoms, five HIV-infected participants would need to be screened with spirometry to diagnose two individuals with any abnormal spirometry pattern. Nearly 40% of a diverse US cohort of HIV-infected individuals had an abnormal spirometry pattern. Specific characteristics including age, smoking status, respiratory infection history and respiratory symptoms can identify those at risk for abnormal spirometry. The high prevalence of abnormal spirometry and the poor predictive capability of respiratory symptoms to identify abnormal spirometry should prompt clinicians to consider screening spirometry in HIV-infected populations.
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Roelofs, J.; Verbraak, M.J.P.M.; Keijsers, G.P.J.; Bruin, M.B.N. de; Schmidt, A.J.M.
2005-01-01
Psychometric properties of the Dutch version of the Maslach Burnout Inventory General Survey, the MBI-DV, were examined in individuals with and without clinical burnout. The factor structure, the utility of the MBI-DV as a screening instrument in addition to a clinical interview for diagnosing
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Use of e-cigarettes by individuals with mental health conditions
Cummins, Sharon E; Zhu, Shu-Hong; Tedeschi, Gary J; Gamst, Anthony C; Myers, Mark G
2014-01-01
Background Individuals with mental health conditions (MHC) have disproportionately high tobacco-related morbidity and mortality due to high smoking prevalence rates. As high consumers of cigarettes, smokers with MHC may consider using e-cigarettes as an alternative form of nicotine delivery. Objective Examination of the susceptibility to use e-cigarettes by individuals with MHC. Methods A US population survey with a national probability sample (n=10 041) was used to assess ever use and current use of regular cigarettes, e-cigarettes, and US Food and Drug Administration-approved pharmacotherapy for smoking cessation. Survey respondents provided information about whether they had been diagnosed with an anxiety disorder, depression, or other MHC. Results Individuals with MHC were more likely to have tried e-cigarettes (14.8%) and to be current users of e-cigarettes (3.1%) than those without MHC (6.6% and 1.1%, respectively; pe-cigarettes than smokers without MHC (60.5% vs 45.3%, respectively, pe-cigarettes. Clinical interventions and policies for tobacco control on e-cigarettes should take into account the possible outcomes and their implications for this priority population. PMID:24824516
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Frequency of nursing diagnoses in a surgical clinic
Directory of Open Access Journals (Sweden)
Andreza Cavalcanti Vasconcelos
2015-12-01
Full Text Available Objective: to identify the frequency of Nursing Diagnoses of patients in a surgical clinic. Methods: cross-sectional study, performed with 99 patients in the postoperative of general surgery. Data were collected through a questionnaire validated according to domains of NANDA International, including physical and laboratory examination. Results: 17 nursing diagnoses were found; eight had a frequency higher than 50.0% (infection risk, impaired tissue integrity, constipation risk, anxiety, bleeding risk, acute pain, delayed surgical recovery, dysfunctional gastrointestinal motility. It was observed in all patients the Nursing Diagnostics: risk of infection, impaired tissue integrity and risk of constipation. Conclusion: the frequency of the most prevalent diagnosis is inserted in the domains safety/protection and nutrition, which determines the need to redirect nursing care, prioritizing the patient's clinic.
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Counselling in infertility: individual, couple and group interventions.
Van den Broeck, Uschi; Emery, Marysa; Wischmann, Tewes; Thorn, Petra
2010-12-01
Infertility is considered a biopsychosocial crisis and infertility counselling is recommended as an integral part of a multidisciplinary approach. This article will outline the theoretical background and describe common interventions used in infertility counselling for individuals, couples and in a group setting. This article summarizes the proceedings of the first campus workshop of the Special interest group of Psychology and Counselling of the European Society for Human Reproduction and Embryology (ESHRE). Infertility counselling offers the opportunity to explore, discover and clarify ways of living more satisfyingly and resourcefully when fertility impairments have been diagnosed. The Heidelberg Fertility Consultation Service is presented as a framework for individual and couples counselling and highlights important issues in counselling patients. For group work a number of steps to set up a group within an infertility framework are discussed. In recent years, infertility counselling has become a specialist form of counselling requiring professional expertise and qualification. Key issues and common interventions are presented to raise awareness for the specific counselling needs of individuals and couples experiencing infertility and undergoing medical treatment. Mental health professionals new to the field of reproductive technologies as well as those in other areas of mental health counselling clients with fertility disorders can benefit from the topics addressed. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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Alienation appraisals distinguish adults diagnosed with DID from PTSD.
DePrince, Anne P; Huntjens, Rafaële J C; Dorahy, Martin J
2015-11-01
Studies are beginning to show the importance of appraisals to different types and severities of psychiatric disorders. Yet, little work in this area has assessed whether trauma-related appraisals can differentiate complex trauma-related disorders, such as posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). The current study evaluated whether any of 6 trauma-related appraisals distinguished adults diagnosed with DID from those diagnosed with PTSD. To accomplish this, we first examined the basic psychometric properties of a Dutch-translated short-form of the Trauma Appraisals Questionnaire (TAQ) in healthy control (n = 57), PTSD (n = 27) and DID (n = 12) samples. The short-form Dutch translation of the TAQ showed good internal reliability and criterion-related validity for all 6 subscales (betrayal, self-blame, fear, alienation, shame, anger). Of the 6 subscales, the alienation appraisal subscale specifically differentiated DID from PTSD, with the former group reporting more alienation. Abuse-related appraisals that emphasize disconnection from self and others may contribute to reported problems of memory and identity common in DID. The current findings suggest that addressing experiences of alienation may be particularly important in treatment for clients diagnosed with DID. (c) 2015 APA, all rights reserved).
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Delayed Diagnoses: Nonspecific Findings and Diagnostic Challenges in Eating Disorders
Directory of Open Access Journals (Sweden)
Dan Schwarz
2009-01-01
Full Text Available Objective. Eating disorders commonly present with nonspecific findings, masquerading as other, more common etiologies of malnutrition and wasting. In low-prevalence populations, these ambiguities can complicate clinicians’ diagnostic reasoning, resulting in delayed or missed diagnoses. Method. We report the atypical case of a 51-year-old male with a five-year history of unexplained weight loss despite extensive past medical evaluation. Previous documentation of profound lymphopenia and bone marrow atrophy had not been linked to a known association with eating disorders. Results. Evaluation for medical etiologies of wasting was negative. Following psychiatric evaluation, the patient was diagnosed with an eating disorder, not otherwise specified, and admitted to a specialized nutritional rehabilitation program. Conclusion. The nonspecific clinical history, physical exam, and laboratory abnormalities of eating disorders can make these diagnoses challenging and delay appropriate treatment. Clinicians should consider eating disorders in patients with malnutrition, severe lymphopenias, and gelatinous marrow transformation early in their workup, so as to avoid potentially negative outcomes.
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Correlation between clinical and histopathological diagnoses in periapical inflammatory lesions.
Diegues, Liliane Lopes; Colombo Robazza, Carlos Roberto; Costa Hanemann, João Adolfo; Costa Pereira, Alessandro Antônio; Silva, Cléverson O
2011-08-01
The purpose of the present study was to evaluate the correlation between clinical and histopathological diagnoses of periapical inflammatory lesions, focusing mainly on cystic conditions. Files dating from 1998 to 2006 at the Oral Pathology Laboratory, School of Dentistry, Alfenas Federal University, Brazil, were reviewed to identify cases with histopathological diagnoses of periapical inflammatory lesions. A total of 1788 files were analyzed, and 255 cases were identified with clinical diagnoses of periapical inflammatory lesions. The most prevalent clinical diagnosis was apical periodontal cyst (59%), followed by periapical granuloma (20%), and dentoalveolar abscess (2%). After histopathological analysis, 53% of the cases represented apical periodontal cyst, 42% periapical granuloma, and 5% dentoalveolar abscess. The outcomes of the present study show a high prevalence of periapical cysts among periapical inflammatory lesions. Moreover, this study highlights the importance of histopathological evaluation for the correct diagnosis of periapical inflammatory lesions. © 2011 Blackwell Publishing Asia Pty Ltd.
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Methods for Fault Diagnosability Analysis of a Class of Affine Nonlinear Systems
Directory of Open Access Journals (Sweden)
Xiafu Peng
2015-01-01
Full Text Available The fault diagnosability analysis for a given model, before developing a diagnosis algorithm, can be used to answer questions like “can the fault fi be detected by observed states?” and “can it separate fault fi from fault fj by observed states?” If not, we should redesign the sensor placement. This paper deals with the problem of the evaluation of detectability and separability for the diagnosability analysis of affine nonlinear system. First, we used differential geometry theory to analyze the nonlinear system and proposed new detectability criterion and separability criterion. Second, the related matrix between the faults and outputs of the system and the fault separable matrix are designed for quantitative fault diagnosability calculation and fault separability calculation, respectively. Finally, we illustrate our approach to exemplify how to analyze diagnosability by a certain nonlinear system example, and the experiment results indicate the effectiveness of the fault evaluation methods.
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The Methods for Diagnosing the Attractiveness of Ecological Entrepreneurship in Rural Areas
Directory of Open Access Journals (Sweden)
Shuliak Bogdan V.
2018-03-01
Full Text Available The study is aimed at substantiating the methods for diagnosing the attractiveness of ecological entrepreneurship in rural areas. The article defines the objectives of diagnosing the attractiveness of ecological entrepreneurship in rural areas. It is determined that the methods for diagnosing the attractiveness of environmentally oriented entrepreneurial activity should take into account its effectiveness in the context of economic, ecological, and social components; current status, dynamics and tendencies of development of basic indicators of attractiveness; relationship between the actual and target values of such indicators. The system of methods which is expedient for use in the process of diagnosing, has been defined as follows: methods of correlation analysis (substantiation of the purposes of diagnostics; coefficient analysis and fuzzy logic methods (estimation of the actual levels of attractiveness indicators; regression analysis and mathematical-statistical method (estimation of tendencies, building of forecasts; cluster analysis, ranking, rationing, and integral estimation (comparative analysis of the estimation results.
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Concomitant HIV infection in newly diagnosed multiple myeloma ...
African Journals Online (AJOL)
RESEARCH ... To compare the presenting features of HIV-positive patients diagnosed with MM ..... Especially since recent publications are showing trends of .... 18. Agrawal S, Deshpande A. A unique presentation of multiple myeloma in an ...
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Homeless Individuals Approaching the End of Life: Symptoms and Attitudes.
Tobey, Matthew; Manasson, Julia; Decarlo, Kristen; Ciraldo-Maryniuk, Katrina; Gaeta, Jessie M; Wilson, Erica
2017-04-01
Over a million individuals in the United States experience homelessness annually and homeless individuals die at a higher rate than domiciled peers. Homeless individuals often have unique experiences at the end of life (EOL). This study examined the symptoms experienced by homeless individuals nearing the EOL and explored social background, attitudes, and experiences. Investigators conducted surveys of homeless individuals approaching the EOL at a medical respite home. Eligibility required a serious medical condition and for the patient's medical provider to answer "no" to the question "Would you be surprised if this patient were not alive in one year?" Interviews explored symptoms using the Memorial Symptom Assessment Survey. Symptoms were compared with those of relevant comparator groups in other studies. Participants (n = 20) were young to face the EOL (median age = 58) and suffered high rates of substance use disorders (n = 18; 90%) and psychiatric diagnoses (n = 16; 80%). Symptom frequency was high, especially as regarded pain and psychological symptoms. Previous experience with death among family and peers was universal (n = 20; 100%). Mistrust of others' decisions about the EOL was common, as was concern about receiving too little (n = 11; 55%) or too much (n = 8; 40%) care at the EOL. The frequency of symptoms was higher than in three comparator studies and those studies' subgroups (P Homeless individuals may experience a high frequency of pain and other symptoms as they approach the EOL. Care for such individuals may require a tailored approach. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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GERD: Diagnosing and treating the burn.
Alzubaidi, Mohammed; Gabbard, Scott
2015-10-01
Gastroesophageal reflux disease (GERD) is chronic, very common, and frequently encountered in internal medicine and subspecialty clinics. It is often diagnosed on clinical grounds, but specialized testing such as endoscopy and pH monitoring may be necessary in certain patients. Although proton pump inhibitors (PPIs) are the mainstay of treatment, clinicians should be aware of their short-term and long-term side effects. Copyright © 2015 Cleveland Clinic.
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Viera, Anthon J; Bond, Michael M; Yates, Scott W
2003-03-01
Night sweats are a common outpatient complaint, yet literature on the subject is scarce. Tuberculosis and lymphoma are diseases in which night sweats are a dominant symptom, but these are infrequently found to be the cause of night sweats in modern practice. While these diseases remain important diagnostic considerations in patients with night sweats, other diagnoses to consider include human immunodeficiency virus, gastroesophageal reflux disease, obstructive sleep apnea, hyperthyroidism, hypoglycemia, and several less common diseases. Antihypertensives, antipyretics, other medications, and drugs of abuse such as alcohol and heroin may cause night sweats. Serious causes of night sweats can be excluded with a thorough history, physical examination, and directed laboratory and radiographic studies. If a history and physical do not reveal a possible diagnosis, physicians should consider a purified protein derivative, complete blood count, human immunodeficiency virus test, thyroid-stimulating hormone test, erythrocyte sedimentation rate evaluation, chest radiograph, and possibly chest and abdominal computed tomographic scans and bone marrow biopsy.
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DEFF Research Database (Denmark)
Skovbjerg, Signe; Zachariae, Robert; Rasmussen, Alice
2010-01-01
perceptions are associated with IEI would add to our understanding of this complex disorder. PURPOSE: To examine if measures of somato-sensory amplification, autonomic perception and absorption are associated with IEI. METHODS: The study included individuals with self-reported or physician-diagnosed IEI....... Participants (n = 732) completed questionnaires that included items on descriptive variables of IEI, the Somato-Sensory Amplification Scale (SSAS), the Autonomic Perception Questionnaire (APQ), the Tellegen Absorption Scale (TAS) and a Negative Affectivity Scale (NAS). RESULTS: Multiple, hierarchical linear...