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Psychosocial Aspects (psychosocial + aspect)

Distribution by Scientific Domains

Medical Sciences	50%
Psychology	11%

Selected Abstracts

Psychosocial Aspects of Patient-Activated Atrial Defibrillation

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 8 2003
Andrew R.J. Mitchell M.R.C.P.
Introduction: The atrial defibrillator empowers patients to cardiovert themselves from atrial arrhythmias at a time that is socially and physically acceptable, thereby preventing hospitalization. The long-term psychosocial effects of repeated use of the patient-activated atrial defibrillator at home are unknown. Methods and Results: Eighteen patients underwent placement of the Jewel AF atrial defibrillator for persistent atrial fibrillation only. All patients performed manually activated cardioversions at home under self-administered sedation. Automatic shock therapies were disabled. Hospital Anxiety and Depression Scale and Multidimensional Health Locus of Control questionnaires were obtained before implant. All patients completed questionnaires 1 year after device implant and at long-term follow-up. The spouse or partner of each patient was interviewed to identify positive and negative aspects of manual cardioversion at home. The baseline patient scores for both anxiety (5.7 ± 2.7) and depression (3.4 ± 2.3) fell within the predefined range of normality. At 1 year, there was no significant change in anxiety (4.9 ± 3.7, P = 0.39) or depression (2.4 ± 1.8, P = 0.06). At long-term follow-up (mean 28 months), a total of 377 patient-activated cardioversions were performed out of hospital (median 15 per patient). Scores for anxiety (6.0 ± 4.0, P = 0.70) and depression (3.2 ± 2.5, P = 0.68) remained unchanged. Conclusion: During long-term follow-up, patient-activated cardioversion using the atrial defibrillator was not associated with increased anxiety or depression. The procedure was well tolerated by patients and their partners, offering an acceptable treatment option for patients with recurrent persistent atrial fibrillation. (J Cardiovasc Electrophysiol, Vol. 14, pp. 812-816, August 2003) [source]

Psychosocial Aspects of Pain: A Handbook for Health Care Providers

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 11 2004
M Craigie Dr
No abstract is available for this article. [source]

Current awareness in prenatal diagnosis

PRENATAL DIAGNOSIS, Issue 7 2008
Article first published online: 15 JUL 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Reviews; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre-implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted [source]

Current awareness in prenatal diagnosis

PRENATAL DIAGNOSIS, Issue 1 2008
Article first published online: 10 JAN 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Reviews; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre-implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted [source]

Current awareness in prenatal diagnosis

PRENATAL DIAGNOSIS, Issue 7 2007
Article first published online: 2 JUL 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Reviews; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre-implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted [source]

Current awareness in prenatal diagnosis

PRENATAL DIAGNOSIS, Issue 10 2006
Article first published online: 9 OCT 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre-implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted [source]

Current awareness in prenatal diagnosis

PRENATAL DIAGNOSIS, Issue 4 2006
Article first published online: 27 MAR 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre-implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted [source]

Current awareness in prenatal diagnosis

PRENATAL DIAGNOSIS, Issue 1 2006
Article first published online: 23 DEC 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre-implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted [source]

Current awareness in prenatal diagnosis

PRENATAL DIAGNOSIS, Issue 10 2004
Article first published online: 25 OCT 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre-implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted [source]

Current awareness in prenatal diagnosis

PRENATAL DIAGNOSIS, Issue 4 2004
Article first published online: 31 MAR 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre-implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted [source]

Current awareness in prenatal diagnosis

PRENATAL DIAGNOSIS, Issue 8 2003
Article first published online: 5 AUG 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre-implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted [source]

Current Awareness in prenatal diagnosis

PRENATAL DIAGNOSIS, Issue 2 2003
Article first published online: 28 JAN 200
In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre-implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted [source]

Organ Transplantation: Ethical, Legal and Psychosocial Aspects,Towards a Common European Policy edited by W. Weimar, M. A. Bos, and J. J. Busschbach

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2009
James S. Taylor
No abstract is available for this article. [source]

Paediatric training for family doctors: principals and practice

MEDICAL EDUCATION, Issue 5 2002
C Melville
Background There is controversy as to how best to train general practitioners for the paediatric challenges they will meet in practice, in particular what should be included in training, what should be left out and how long should it last? Subjects and methods All 615 general practice principals referring to 6 hospitals were surveyed (40% response rate). Setting West Midlands region of England. Study design Postal questionnaire. Statistics Quantitative and qualitative assessment of responses. Quantitative responses were analysed by hospital, decade of qualification, and duration of paediatric training. Qualitative responses were analysed using grounded theory. Results Satisfaction with training was directly related to its duration, with low levels of satisfaction for less than 6 months paediatrics, moderate levels for 6,11 months, and high levels with 12 months or more. The most important item of training was recognition of the sick child. Acute and chronic paediatrics was generally well covered. Psychosocial aspects, public health and immunisation were poorly addressed. Neonatal resuscitation and first day checks were seen as relevant, but neonatal intensive care was not. Conclusions At least 6 months of paediatrics is necessary for GPs in training, but longer paediatric exposure further increases their satisfaction with training. GPs have a biopsychosocial rather than biomedical approach to their child patients, suggesting potential benefits from a greater emphasis on psychosocial and public health aspects at the expense of neonatal intensive care. Recognition of the sick child is essential, and acute and chronic organic illness should be covered in breadth. Possible future models for GP training in paediatrics are discussed. [source]

Gastroesophageal reflux: prevalence of psychopathological disorders and quality of life implications

DISEASES OF THE ESOPHAGUS, Issue 5 2006
Á. Díaz de Liaño
SUMMARY., There is evidence in the literature that psychosocial aspects affect the symptoms and results of surgery for gastroesophageal reflux. The purpose of this study was to estimate the prevalence of psychopathological disorders measured using the General Health Questionnaire (GHQ-28) in a sample of patients with gastroesophageal reflux, and to assess the influence of such disorders on their quality of life. A prospective study was conducted in 74 consecutive patients before gastroesophageal reflux surgery; patients answered the GHQ-28, the health questionnaire SF-36, and the Gastrointestinal Quality of Life Index (GIQLI). The convergent validity of the GHQ-28 questionnaire as compared to the other two questionnaires and preoperative quality of life was tested. A pathological result of the GHQ-28 questionnaire was found in 38.3% of patients. A correlation was seen between the results of the GHQ-28 questionnaire and all categories of the SF-36 and GIQLI questionnaires. Patients with pathological results in the GHQ-28 questionnaire had poorer results in all dimensions of the SF-36 and GIQLI quality of life questionnaires as compared to patients with a normal result in the GHQ-28 questionnaire. In conclusion, 38.3% of patients with gastroesophageal reflux showed psychopathological disorders when administered the GHQ-28 questionnaire. These patients also had poorer results in quality of life studies. [source]

Perception and integration of people living with type 1 diabetes , an empirical study

EUROPEAN DIABETES NURSING, Issue 1 2006
M Due-christensen RN Diabetes Nurse
Abstract Background: The chronic complications of type 1 diabetes impose a heavy physical, psychological and social burden on people living with the condition. Improved metabolic control reduces the risk of developing chronic complications and could lead to improved well-being for people with diabetes. Aims: The aim of this study was to explore the perceptions of adults with type 1 diabetes who have improved their metabolic control with respect to acceptance, knowledge, social support and their relationships with healthcare providers. Methods: The study included ten people with type 1 diabetes who had achieved and maintained a reduction of 1.5% in their HbA1C during a one-year period. A phenomenological qualitative semi-structured interview was used in the collection of information from the participants. The interviews were analysed using the method of meaning condensation; these were interpreted from a perspective of integration. Results: The study shows differences among people living with diabetes regarding their perceptions of living with the condition. The people have at least three different strategies of integrating diabetes, based on their perception. Conclusions: Integration is a life-long process and in this process, the person with diabetes has to learn to integrate diabetes into both behavioural and psychosocial aspects of life. [source]

Quantitative and qualitative methods in UK health research: then, now and . . . ?

EUROPEAN JOURNAL OF CANCER CARE, Issue 3 2002
K. Mcpherson phd
Quantitative and qualitative methods in UK health research: then, now and . . . ? This paper examines the current status of qualitative and quantitative research in the context of UK (public) health research in cancer. It is proposed that barren competition between qualitative and quantitative methods is inevitable, but that effective synergy between them continues to be essential to research excellence. The perceived methodological utility, with respect to understanding residual uncertainties, can account for the status accorded various research techniques and these will help to explain shifts witnessed in recent years and contribute towards an understanding of what can be realistically expected in terms of future progress. It is argued that the methodological debate, though familiar to many, is worthy of rearticulation in the context of cancer research where the psychosocial aspects of living with a cancer and the related complexity of providing appropriate cancer care are being addressed across Europe, as evidenced in recent directions in policy and research. [source]

A literature review of spirituality in coping with early-stage Alzheimer's disease

JOURNAL OF CLINICAL NURSING, Issue 5a 2008
Linda Beuscher PhD
Aims., This paper presents a literature review focusing on the use of spirituality in coping by older persons with early-stage Alzheimer's disease from their perspectives. The purpose of this literature review is to examine the existing body of knowledge about spirituality in coping with Alzheimer's disease and to apply a spiritual framework of coping in organizing the literature to identify themes and gaps in knowledge. Background., Despite the abundance of Alzheimer's disease research, little is known about how older persons with this devastating disease cope with the consequential losses. Maintaining a sense of normalcy and preserving self-worth are coping strategies reported by older persons with early-stage Alzheimer's disease. As spirituality is an effective coping resource for older persons with numerous psychological and personal losses in their lives, it may be an important coping resource for person with Alzheimer's disease. Method., A literature search was conducted to find research published between 1990,2006 aimed at understanding spirituality in coping with early-stage Alzheimer's disease. Conclusions., Six research studies were reviewed. Findings suggest that persons with early-stage Alzheimer's disease draw from their spirituality and faith to find meaning and courage in facing the challenges of cognitive losses. Furthermore, they are able to provide rich information about their spirituality and the psychosocial aspects of living with Alzheimer's disease. Limited empirical knowledge compels the need for future research to explore how spirituality is utilized in coping with early-stage Alzheimer's disease. Relevance to clinical practice., Enhancing persons' abilities to cope effectively with their diseases is an important goal of nursing care. Understanding how older persons with Alzheimer's disease cope with their memory loss is critical to the development of evidence-based interventions to minimize the stress of living with this disease. [source]

Responding to society's needs: Prescription privileges for psychologists

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 6 2002
Mary Ann Norfleet
The health care revolution has contributed to the natural evolution of the role of psychologists. This has led to the necessity for future psychologists to have the authority to prescribe psychotropic medications in order to offer the best-available, comprehensive treatment to the public. Psychologists' training gives them a unique role in addressing the psychosocial aspects of medical problems, in collaboration with primary-care physicians. Prescribing psychologists are cost-effective, many practice in rural areas where people have no other access to mental health care, and they will be able to treat other underserved populations such as the poor, the elderly, the chronically mentally ill, children, and prisoners in the criminal justice system. Prescribing psychologists will have an increasingly prominent role in future health care policy decisions and practice. © 2002 Wiley Periodicals, Inc. J Clin Psychol 58: 599,610, 2002. [source]

Applying the developmental perspective in the psychiatric assessment and diagnosis of persons with intellectual disability: part I , assessment

JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 1 2005
A. Dosen
Abstract Background In generic psychiatry there has been increasing interest among scientists for the developmental perspective. However, professionals active in the mental health care of people with intellectual disability (ID) have not shown the same degree of interest. The author of this article, who has had a liberal amount of rewarding experiences with the developmental approach in the field of ID, considers the developmental perspective to be innovative and very useful in psychiatric assessment, diagnosis and treatment of this population. The aim of the article is to stimulate a wider application of the developmental perspective as well as to challenge a professional discussion on this issue. Methods Basic assumptions of the developmental perspective are discussed and assessment tools and methods are described. Results In a case vignette, the advantages of developmentally based assessment are emphasized. Emotional development and personality development are viewed as the developmental components that play an important role in adaptive and maladaptive behaviour as well as in the onset and presentation of psychopathology. It is clear that interpretative insight into the totality of the psychosocial aspects of these individuals cannot only be obtained by measuring the level of cognitive development. A wider frame of mind is needed for unambiguous psychiatric diagnostics. Therefore, a replacement of the three dimensional paradigm (bio,psycho,social) by a four dimensional one (bio,psycho,socio,developmental) for the assessment and diagnosis of persons with ID is proposed. [source]

Psychosocial issues in genetic testing for familial adenomatous polyposis: a review of the literature

PSYCHO-ONCOLOGY, Issue 8 2008
K. F. L. Douma
Abstract Objectives: Familial adenomatous polyposis (FAP) is characterized by the development of multiple adenomas in the colon that can lead to colorectal cancer. Being a carrier for FAP is hypothesized to have a negative impact on psychosocial well-being. This paper reviews the current literature on the psychosocial aspects of FAP. Methods: Four literature databases were used to identify all papers published between 1986 and 2007 about psychosocial and behavioral issues in FAP related to genetic testing. The following topics were reviewed: uptake and psychosocial impact of genetic testing, endoscopic screening behavior and psychosocial well-being in general. Results: Seventeen papers were identified. Across studies, genetic test uptake varied between 62 and 97%. Two out of three studies showed clinical levels of anxiety and/or depression after genetic testing. A minority of individuals were not reassured by a negative test result, and intended to continue endoscopic surveillance. Well-being (e.g. quality of life, family functioning) was found to be lower in some studies, while comparable to the general population in other studies. The studies had several shortcomings, such as mixed patient population (e.g. colorectal and breast cancer) and small sample sizes, and provided no information on other potentially important issues, such as psychosexual development. Conclusions: Future studies should employ larger sample sizes and standardized measurements. Additionally, future studies should address the long-term consequences of genetic testing for FAP, psychosexual development and consequences of FAP for the family as a whole. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Chylous Ascites Requiring Surgical Intervention after Donor Nephrectomy: Case Series and Single Center Experience

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2010
J. Aerts
Chylous ascites as a result of laparoscopic donor nephrectomy (LDN) is a rare complication that carries significant morbidity, including severe protein-calorie malnutrition and an associated immunocompromised state. We report a patient who underwent hand-assisted left LDN and subsequently developed chylous ascites. He failed conservative therapy including low-fat diet with medium-chain triglycerides (LFD/MCT) and oral protein supplementation as well as strict NPO status with intravenous (IV) total parenteral nutrition (TPN) and subcutaneous (SQ) somatostatin analogue administration. Laparoscopic re-exploration and intracorporeal suture ligation and clipping of leaking lymph channels successfully sealed the chyle leak. We review the literature to date including diagnosis, incidence, management options, psychosocial aspects and clinical outcomes of chylous ascites after LDN. [source]

Psychiatric morbidity in psoriasis: A review

AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 3 2004
Paul AJ Russo
SUMMARY Psoriasis is a common condition, affecting 1.5,2% of the population of industrialized countries. It is important for clinicians to be aware that psoriasis can have a substantial emotional impact on an individual, which is not necessarily related to the extent of skin disease. This review examines current literature addressing the psychological and emotional aspects of psoriasis. A literature search of the MEDLINE (1966,2002) and PsycINFO (1984,2002) computer databases and bibliographies was carried out. Papers selected for the review included English language reviews and all original research relevant to the topic, in the form of randomized controlled trials, cohort studies, case,control studies, cross-over and uncontrolled clinical trials, patient surveys, quality-of-life studies, case series and case reports. Despite significant shortcomings, the available prevalence studies showed uniformly high rates of psychopathology among psoriasis sufferers. The few intervention studies available are summarized and critically discussed. Psoriasis is associated with a variety of psychological problems, including poor self esteem, sexual dysfunction, anxiety, depression and suicidal ideation. The clinical severity of the psoriasis may not reflect the degree of emotional impact of the disease. A number of psychological interventions have shown promise in recent trials. It is important that clinicians consider the psychosocial aspects of this illness. [source]

Effects of gynaecological education on interpersonal communication skills

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2001
A.M. van Dulmen
Objective To investigate the effects of an experimental communication course on how gynaecologists handle psychosocial issues in gynaecological consultation. Design Pre-post testing. Multilevel analysis was used to take into account the similarity among encounters with the same gynaecologist. Sample Eighteen gynaecologists (13 consultants and 5 junior doctors) from five different hospitals participated. All gynaecologists videotaped consecutive outpatient encounters before and after attending an intensive training course. Main outcome measures The communicative performance of the gynaecologists at pre-and post measurement. Results The gynaecologists recorded a total of 526 outpatient encounters, 272 before and 254 after the training. As a result of the training, gynaecologists' sensitivity to psychosocial aspects of their patients increased. At post measurement, the gynaecologists gave more signs of agreement, became less directive, asked fewer medical questions and more psychosocial questions. No difference was found in the duration of the outpatient visits. With the trained gynaecologists, patients asked more questions and provided more psychosocial information. Conclusions Junior doctors and clinically experienced gynaecologists can be taught to handle psychosocial issues without lengthening the visit. [source]

The Interface Between Physical and Mental Health Problems and Medical Help Seeking in Children and Adolescents: A Research Perspective

CHILD AND ADOLESCENT MENTAL HEALTH, Issue 4 2004
M. Elena Garralda
This paper addresses child and adolescent psychopathology as it presents to general practitioners and paediatricians, and explores psychosocial aspects of unexplained medical symptoms in children and adolescents. High rates of psychopathology have been identified amongst children and adolescents attending general practice and paediatric services, most of it ,,hidden'' at presentation and emotional in nature. It is often linked to poor physical well being and to maternal stress focused on the child. It may be of special relevance to medical help seeking in socio-economically advantaged areas. Co-morbid psychopathology, mainly emotional disorders, is common amongst children with unexplained medical symptoms. However, there are specific psychosocial aspects that differentiate these children from those with emotional disorders. They involve disease beliefs, illness behaviour and predicament. The latter may be characterised by special reactivity to stress in children with personality vulnerability, in a context of parents with high levels of mental distress, unexplained medical symptoms and emotional over-involvement with the child. There is comparatively little interface work between CAMHS and primary health care. An important research priority would seem to lie in the development of interventions that can be adapted for use by primary care staff. Similarly, there are few dedicated CAMHS paediatric liaison teams. Their more extensive development should help attend in a more informed and focused way than at present to children and adolescents suffering from unexplained physical symptoms and disorders. Further research is needed into vulnerability mechanisms and maintaining factors, health beliefs, treatment engagement and interventions. [source]