6,730 research outputs found
Psychometric properties of the Mental Health Recovery Star.
No full textBACKGROUND: The Mental Health Recovery Star (MHRS) is a popular outcome measure rated collaboratively by staff and service users, but its psychometric properties are unknown. AIMS: To assess the MHRS's acceptability, reliability and convergent validity. METHOD: A total of 172 services users and 120 staff from in-patient and community services participated. Interrater reliability of staff-only ratings and test-retest reliability of staff-only and collaborative ratings were assessed using intraclass correlation coefficients (ICCs). Convergent validity between MHRS ratings and standardised measures of social functioning and recovery was assessed using Pearson correlation. The influence of collaboration on ratings was assessed using descriptive statistics and ICCs. RESULTS: The MHRS was relatively quick and easy to use and had good test-retest reliability, but interrater reliability was inadequate. Collaborative ratings were slightly higher than staff-only ratings. Convergent validity suggests it assesses social function more than recovery. CONCLUSIONS: The MHRS cannot be recommended as a routine clinical outcome tool but may facilitate collaborative care planning
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Gorlin syndrome in a patient with skin type VI
Get PDFGorlin syndrome, also known as nevoid basal cell carcinoma syndrome, is a rare autosomal dominant disorder that is characterized by multiple basal cell carcinomas developing at a young age, keratocystic odontogenic tumors of the jaw, palmar or plantar pits, calcification of the falx cerebri, and skeletal abnormalities. Nevoid basal cell carcinoma syndrome is caused by mutations in the PTCH1 or SUFU genes. Our patient with Fitzpatrick skin type VI was diagnosed with Gorlin syndrome based on the presentation of multiple major diagnostic characteristics. Although he is 33 years old, he has not developed any multiple basal cell carcinomas to date
Enhancing Social Connectedness in Anxiety and Depression Through Amplification of Positivity: Preliminary Treatment Outcomes and Process of Change.
Get PDFBackgroundAnxiety and depressive disorders are often characterized by perceived social disconnection, yet evidence-based treatments produce only modest improvements in this domain. The well-established link between positive affect (PA) and social connectedness suggests that directly targeting PA in treatment may be valuable.MethodA secondary analysis of a waitlist-controlled trial (N=29) was conducted to evaluate treatment response and process of change in social connectedness within a 10-session positive activity intervention protocol-Amplification of Positivity (AMP)-designed to increase PA in individuals seeking treatment for anxiety or depression (ClinicalTrials.gov Identifier: NCT02330627). Perceived social connectedness and PA/negative affect (NA) were assessed throughout treatment. Time-lagged multilevel mediation models examined the process of change in affect and connectedness throughout treatment.ResultsThe AMP group displayed significantly larger improvements in social connectedness from pre- to post-treatment compared to waitlist; improvements were maintained through 6-month follow-up. Within the AMP group, increases in PA and decreases in NA both uniquely predicted subsequent increases in connectedness throughout treatment. However, experiencing heightened NA throughout treatment attenuated the effect of changes in PA on connectedness. Improvements in connectedness predicted subsequent increases in PA, but not changes in NA.ConclusionsThese preliminary findings suggest that positive activity interventions may be valuable for enhancing social connectedness in individuals with clinically impairing anxiety or depression, possibly through both increasing positive emotions and decreasing negative emotions
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The Jet-Driven Outflow In The Radio Galaxy SDSS J1517+3353: Implications For Double-Peaked Narrow-Line Active Galactic Nucleus
Get PDFWe report on the study of an intriguing active galaxy that was selected as a potential multiple supermassive black hole merger in the early-type host SDSS J151709.20+335324.7 (z = 0.135) from a complete search for double-peaked [O III] lines from the SDSS spectroscopic quasi-stellar object (QSO) database. Ground-based SDSS imaging reveals two blue structures on either side of the photometric center of the host galaxy, separated from each other by about 5.7 kpc. From a combination of SDSS fiber and Keck/HIRES long-slit spectroscopy, it is demonstrated that, in addition to these two features, a third distinct structure surrounds the nucleus of the host galaxy. All three structures exhibit highly ionized line emission with line ratios characteristic of Seyfert II active galactic nuclei. The analysis of spatially resolved emission-line profiles from the HIRES spectrum reveal three distinct kinematic subcomponents, one at rest and the other two moving at -350 km s(-1) and 500 km s(-1) with respect to the systemic velocity of the host galaxy. A comparison of imaging and spectral data confirm a strong association between the kinematic components and the spatial knots, which implies a highly disturbed and complex active region in this object. A comparative analysis of the broadband positions, colors, kinematics, and spectral properties of the knots in this system lead to two plausible explanations: (1) a multiple active galactic nucleus (AGN) produced due to a massive dry merger, or (2) a very powerful radio jet-driven outflow. Subsequent VLA radio imaging reveals a clear jet aligned with the emission-line gas, confirming the latter explanation. We use the broadband radio measurements to examine the impact of the jet on the interstellar medium of the host galaxy, and find that the energy in the radio lobes can heat a significant fraction of the gas to the virial temperature. Finally, we discuss tests that may help future surveys distinguish between jet-driven kinematics and true black-hole binaries. J1517+3353 is a remarkable laboratory for AGN feedback and warrants deeper follow-up study. In the Appendix, we present high-resolution radio imaging of a second AGN with double-peaked [O III] lines, SDSS J112939.78+605742.6, which shows a sub-arcsecond radio jet. If the double-peaked nature of the narrow lines in radio-loud AGNs are generally due to radio jet interactions, we suggest that extended radio structure should be expected in most of such systems.NSF AST-0507483, AST-0808133University of Texas at AustinAlfred P. Sloan FoundationParticipating InstitutionsNational Aeronautics and Space AdministrationU.S. Department of EnergyJapanese MonbukagakushoMax Planck SocietyAstronom
Strategies for the Management of Postoperative Anemia in Elective Orthopedic Surgery
Get PDFObjective: To assess the use of oral iron, intravenous (IV) iron, and erythropoiesis-stimulating agents (ESAs) for the prevention and management of perioperative anemia in elective orthopedic surgery patients, and to provide a clinical algorithm for use. Data Sources: A PubMed and MEDLINE search was conducted from 1964 through March 2016 using the following search terms alone or in combination: orthopedic, surgery, elective, anemia, blood transfusion, iron, erythropoiesisstimulating agents, and erythropoietin. Study Selection and Data Extraction: All English-language prospective and retrospective human studies and meta-analyses evaluating oral iron, IV iron, or ESA alone or in combination in elective orthopedic surgery patients were evaluated, provided they reported blood transfusion outcomes. Data Synthesis: A total of 9 prospective and retrospective studies and 1 meta-analysis were identified and included. In the preoperative setting, administration of oral iron, IV iron, or ESA alone or in combination to correct underlying anemia led to significantly reduced transfusion rates. Transfusion requirements were generally less with combination therapy (ESA + oral or IV iron). In the short-term perioperative or postoperative period, use of oral or IV iron led to conflicting results, with some reporting a statistically significant reduction in blood transfusions, whereas others reported none. Conclusions: In elective orthopedic surgery, IV or oral iron with or without an ESA may provide benefit in prevention of postoperative anemia and results in blood transfusion reduction without significantly increasing the risk of adverse events. These agents should be considered at the lowest effective dose with emphasis on administration prior to planned surgery
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Tufted angioma presenting with subclinical coagulopathy
Get PDFTufted angioma is a rare, benign vascular tumor of uncertain pathogenesis, characterized histopathologically by "tufts" of capillaries within the dermis. A life-threatening coagulopathy, Kasabach-Merritt phenomenon, occurs in approximately 10% of cases of tufted angioma and is characterized by profound thrombocytopenia and fibrinogen consumption. We present an asymptomatic 10-month-old boy who presented with an erythematous patch of the right upper extremity and subsequently was diagnosed by biopsy with tufted angioma. Baseline laboratory workup of our patient revealed mildly decreased fibrinogen and elevated D-dimer levels without thrombocytopenia or elevated partial thromboplastin time. This suggests that asymptomatic patients with tufted angioma may present with coagulopathy in the absence of Kasabach-Merritt phenomenon. This also highlights the importance of obtaining baseline laboratory workup in patients presenting with tufted angioma
The clinical effectiveness of different parenting programmes for children with conduct problems : a systematic review of randomised controlled trials
Get PDFBackground
Conduct problems are common, disabling and costly. The prognosis for children with conduct problems is poor, with outcomes in adulthood including criminal behaviour, alcoholism, drug abuse, domestic violence, child abuse and a range of psychiatric disorders.
There has been a rapid expansion of group based parent-training programmes for the treatment of children with conduct problems in a number of countries over the past 10 years. Existing reviews of parent training have methodological limitations such as inclusion of non-randomised studies, the absence of investigation for heterogeneity prior to meta-analysis or failure to report confidence intervals.
The objective of the current study was to systematically review randomised controlled trials of parenting programmes for the treatment of children with conduct problems.
Methods
Standard systematic review methods were followed including duplicate inclusion decisions, data extraction and quality assessment. Twenty electronic databases from the fields of medicine, psychology, social science and education were comprehensively searched for RCTs and systematic reviews to February 2006.
Inclusion criteria were: randomised controlled trial; of structured, repeatable parenting programmes; for parents/carers of children up to the age of 18 with a conduct problem; and at least one measure of child behaviour. Meta-analysis and qualitative synthesis were used to summarise included studies.
Results
57 RCTs were included. Studies were small with an average group size of 21. Meta-analyses using both parent (SMD -0.67; 95% CI: -0.91, -0.42) and independent (SMD -0.44; 95% CI: -0.66, -0.23) reports of outcome showed significant differences favouring the intervention group. There was insufficient evidence to determine the relative effectiveness of different approaches to delivering parenting programmes.
Conclusion
Parenting programmes are an effective treatment for children with conduct problems. The relative effectiveness of different parenting programmes requires further research
Improved synchronous production of Plasmodium falciparum gametocytes in vitro.
No full textThe sexual stages of the Plasmodium falciparum life cycle are attractive targets for vaccines and transmission blocking drugs. Difficulties in culturing and obtaining large amounts of sexual stage P. falciparum parasites, particularly early stages, have often limited research progress in this area. We present a new protocol which simplifies the process of stimulating gametocytogenesis leading to improved synchronous gametocyte production. This new method can be adapted to enrich for early stage gametocytes (I and II) with a higher degree of purity than has previously been achieved, using MACS magnetic affinity columns. The protocol described lends itself to large scale culturing and harvesting of synchronous parasites suitable for biochemical assays, northern blots, flow cytometry, microarrays and proteomic analysis
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