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Clinical Relationships (clinical + relationships)

Distribution by Scientific Domains

Medical Sciences	80%

Selected Abstracts

Treatment of insomnia in patients with mood disorders

DEPRESSION AND ANXIETY, Issue 1 2001
Peter D. Nowell M.D.
Abstract Mood disorders and chronic insomnia share complex theoretical and clinical relationships. This article reviews the subjective symptoms and polysomnographic findings of subjects with mood and insomnia syndromes. The polysomnographic findings reviewed include macro-architectural and micro-architectural data. Various treatments of patients with insomnia and mood disorders will be presented, including both behavioral and pharmacological interventions. Depression and Anxiety 14:7,18, 2001. © 2001 Wiley-Liss, Inc. [source]

User satisfaction with services in a randomised controlled trial of adolescent anorexia nervosa

EUROPEAN EATING DISORDERS REVIEW, Issue 5 2009
Peter Roots
Abstract Background User satisfaction is a neglected outcome in adolescent anorexia nervosa especially since the relative effectiveness of different treatments is unclear. It may also affect clinical outcome. Aims To assess young person's and parents' satisfaction with CAMHS outpatient, specialist outpatient and inpatient treatment received in a large randomised controlled trial. Method Quantitative and qualitative analysis of questionnaire data from 215 young people and their parents followed by focus groups to further explore emerging themes. Results High levels of satisfaction were reported, more amongst parents than young people and with specialist services. Both young people and carers strongly valued clinical relationships that involved being listened to and understood. They valued the expertise of specialist rather than generic CAMHS services. There were polarised views on the influence of other young people in inpatient units. Parents in particular valued support for themselves, both from professionals and other parents and felt this, and sibling support was lacking. Conclusions All comprehensive CAMH services are able to provide the good generic psychotherapeutic skills that parents and young people value so highly. However, generic CAMHS struggle to provide the demanded level of expertise and more specialised individual and family therapeutic interventions. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

Expression profiles and clinical relationships of ID2, CDKN1B, and CDKN2A in primary neuroblastoma

GENES, CHROMOSOMES AND CANCER, Issue 4 2004
Sigrun Gebauer
Despite considerable research into the etiology of neuroblastoma, the molecular basis of this disease has remained elusive. In contrast to the absence of expression of the known tumor suppressor CDKN2A (also known as p16 and INK4A) in a wide variety of tumor types we have found in previous studies that CDKN2A protein is paradoxically highly expressed in many advanced stage neuroblastomas and unrelated to RB1 status. In the present study, we sought to identify the mechanistic relationships that might influence CDKN2A expression and negate its influence on tumor cell proliferation. In this regard, we examined the role of the tumor-suppressor gene CDKN1B (also known as p27 and Kip1) and the oncogene ID2 in relationship to CDKN2A expression, MYCN amplification, and neuroblastoma pathogenesis in 17 neuroblastoma cell lines and 129 samples of primary tumors of all stages. All neuroblastoma cell lines expressed the ID2 transcript and protein. However, although the majority of primary neuroblastomas also expressed the ID2 transcript, expression of the ID2 protein was undetectable or only barely detectable, regardless of transcript expression. In both cell lines and primary tumors, ID2 expression was independent of both CDKN2A and MYCN expression. In primary neuroblastomas, CDKN1B protein was expressed in significantly fewer advanced-stage neuroblastomas than early-stage neuroblastomas, but its expression had no relationship with CDKN2A expression or MYCN amplification. We concluded that the paradoxical expression of CDKN2A in neuroblastoma cannot be explained by inactivation of the tumor-suppressor gene CDKN1B or overexpression of the oncogene ID2. We further concluded that ID2 is not a target of MYCN regulation nor is it a prognostic factor for neuroblastoma. Finally, the loss of CDKN1B in advanced-stage neuroblastoma suggests this protein may play a role in the neuroblastoma disease process. © 2004 Wiley-Liss, Inc. [source]

The emancipation of nursing practice: Applying anti-psychiatry to the therapeutic community

INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2001
Anthony Paul O'Brien
ABSTRACT This paper raises issues about the process and conduct of clinical relationships with people diagnosed as mentally ill who live in therapeutic communities. This clinical work is of particular importance in the late 1990s due to the changing socio-cultural climate of interaction with people living with mental illness. This climate has a focus of care on recovery in the community and not on long-term hospitalization. The paper takes the position of anti-psychiatry as a preferred model of intervention because it is person and not diagnosis oriented. The nature of the therapeutic community is explored in relation to its importance in the context of destigmatizing mental illness, its structure, and in its ability to empower the person from a philosophically driven and experiential perspective. [source]

Retrospective review of children presenting with non cystic fibrosis bronchiectasis: HRCT features and clinical relationships,

PEDIATRIC PULMONOLOGY, Issue 2 2003
E.A. Edwards FRACP
Abstract Non cystic fibrosis (CF) bronchiectasis in children presents with a spectrum of disease severity. Our aims were to document the extent and severity of disease in children with non-CF bronchiectasis, to review the inter- and intraobserver agreement for the high-resolution computed tomography (HRCT) features examined, and to assess correlations between HRCT features and clinical measures of severity. We performed a retrospective review of 56 children from the Starship Children's Hospital. HRCT scans were scored by a modified Bhalla system, and the chest X-rays using the Brasfield score. Scores were correlated with demographics, number of hospitalizations, disease duration, pulmonary function, clinical examination, and chronic sputum infection. The bronchiectasis seen was widespread and severe, particularly in Maori and Pacific Island children. The kappa coefficient for intraobserver agreement was better than that for interobserver agreement. Comparisons between HRCT scan and lung function parameters showed that the strongest relationships were between forced expiratory volume in 1 sec (FEV1) and forced expiratory flow between 25,75% of forced vital capacity (FEF25,75) with the extent of bronchiectasis, bronchial wall thickening, and air trapping. Children with digital clubbing and chest deformity showed significantly higher scores for extent of bronchiectasis, bronchial wall dilatation and thickness, and overall computed tomography (CT) score. No relationship was demonstrated between chronic sputum infection and CT score. The HRCT score demonstrated a stronger correlation between the extent and severity of bronchiectasis, and spirometry values, than the chest X-ray score. In conclusion, pediatric non-CF bronchiectasis in Auckland is extensive and severe. The good intraobserver ratings mean that consistency of scoring is possible on repeated scans. This study cannot comment on the relationships of CT and less severe disease. Pediatr Pulmonol. 2003; 36:87,93. © 2003 Wiley-Liss, Inc. [source]