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Screening Test (screening + test)
Kinds of Screening Test Selected AbstractsESTIMATING THE FALSE NEGATIVE FRACTION FOR A MULTIPLE SCREENING TEST FOR BOWEL CANCER WHEN NEGATIVES ARE NOT VERIFIEDAUSTRALIAN & NEW ZEALAND JOURNAL OF STATISTICS, Issue 4 2004Chris J. Lloyd Summary This paper aims to estimate the false negative fraction of a multiple screening test for bowel cancer, where those who give negative results for six consecutive tests do not have their true disease status verified. A subset of these same individuals is given a further screening test, for the sole purpose of evaluating the accuracy of the primary test. This paper proposes a beta heterogeneity model for the probability of a diseased individual ,testing positive' on any single test, and it examines the consequences of this model for inference on the false negative fraction. The method can be generalized to the case where selection for further testing is informative, though this did not appear to be the case for the bowel-cancer data. [source] Alcohol expectancies in convicted rapists and child molestersCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2001Anu S. Aromäki PhD Background Previous findings suggest that cognitive factors and expectancies related to drinking can mediate subjective sexual arousal as well as aggression in men. Our aim was to investigate the drinking habits and alcohol-related expectancies that might predispose men to sexually aggress in two groups of sexual offenders. Method Men convicted of rape (n = 10) were compared with men convicted of child molesting (n = 10) and with control subjects (n = 31). Current drinking habits (while not in prison) were assessed by self-report, and the extent of alcohol abuse was mapped by the Michigan Alcoholism Screening Test (MAST; Selzer, 1971). Cognitive expectancies related to alcohol use were explored by the standard Alcohol Expectancy Questionnaire (AEQ; Brown et al., 1980). Results The majority of the men who committed rape (70%) but only a third of the men convicted of child molesting were diagnosed with antisocial personality disorder. Alcohol abuse was common in men convicted of both rape and child molesting and the men convicted of rape expected significantly more positive effects from drinking than the control group. Both sex offender groups were the only groups to express significant alcohol-related cognitive expectancies linked to arousal and aggression. Expectancy patterns were directly linked to the antisocial personality characteristics. Conclusion Alcohol abuse is common in men who commit both rape and child molesting. Heavy drinking and the anticipation of alcohol effects such as sexual enhancement, arousal and aggression may facilitate sexual aggression in offenders with antisocial personality disorder. Copyright © 2001 Whurr Publishers Ltd. [source] Validation of the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): report of results from the Australian siteDRUG AND ALCOHOL REVIEW, Issue 3 2005DAVID A. L. NEWCOMBE Abstract The concurrent, construct, discriminative and predictive validity of the World Health Organization's Alcohol Substance Involvement Screening Test (ASSIST) were examined in an Australian sample. One hundred and fifty participants, recruited from drug treatment (n = 50) and primary health care (PHC) settings (n = 100), were administered a battery of instruments at baseline and a modified battery at 3 months. Measures included the ASSIST; the Addiction Severity Index-Lite (ASI-Lite); the Severity of Dependence Scale (SDS); the MINI International Neuropsychiatric Interview (MINI-Plus); the Rating of Injection Site Condition (RISC); the Drug Abuse Screening Test (DAST); the Alcohol Use Disorders Identification Test (AUDIT); the Revised Fagerstrom Tolerance Questionnaire (RTQ); and the Maudsely Addiction Profile (MAP). Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from the ASI-lite, SDS, AUDIT and DAST; and significantly greater ASSIST scores for those with diagnoses of abuse or dependence. Construct validity was established by significant correlations between ASSIST scores and measures of risk factors for the development of drug and alcohol problems. Participants diagnosed with attention deficit/hyperactivity disorder or antisocial personality disorder had significantly higher ASSIST scores than those not diagnosed as such. Discriminative validity was established by the capacity of the ASSIST to discriminate between substance use, abuse and dependence. ROC analysis was able to establish cut-off scores for an Australian sample, with suitable specificities and sensitivities for most substances. Predictive validity was demonstrated by similarity in ASSIST scores obtained at baseline and at follow-up. The findings demonstrated that the ASSIST is a valid screening test for psychoactive substance use in individuals who use a number of substances and have varying degrees of substance use. [source] Measurement mischief: A critique of Reynolds, Nicolson and Hambly (2003)DYSLEXIA, Issue 3 2003Chris Singleton Abstract Reynolds, Nicolson and Hambly (2003) report an intervention study of the effects of exercise-based training on literacy development, using literacy measures from the Dyslexia Screening Test (DST), the NFER-Nelson Group Reading Test, and the Standard Assessment Tasks (SATs). Investigation of the nature and psychometric characteristics of these measures casts serious doubt on their appropriateness in a study of this nature. Consideration of the findings obtained using these measures does not support the authors' conclusion that reading was improved by the intervention. The study by Reynolds et al. does not demonstrate that exercise-based treatment improves literacy skills and the use of its purported findings as evidence that exercise-based treatment would be beneficial for children with literacy difficulties is scientifically untenable. Copyright © 2003 John Wiley & Sons, Ltd. [source] Brief screening questionnaires to identify problem drinking during pregnancy: a systematic reviewADDICTION, Issue 4 2010Ethel Burns ABSTRACT Aims Although prenatal screening for problem drinking during pregnancy has been recommended, guidance on screening instruments is lacking. We investigated the sensitivity, specificity and predictive value of brief alcohol screening questionnaires to identify problem drinking in pregnant women. Methods Electronic databases from their inception to June 2008 were searched, as well as reference lists of eligible papers and related review papers. We sought cohort or cross-sectional studies that compared one or more brief alcohol screening questionnaire(s) with reference criteria obtained using structured interviews to detect ,at-risk' drinking, alcohol abuse or dependency in pregnant women receiving prenatal care. Results Five studies (6724 participants) were included. In total, seven instruments were evaluated: TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), T-ACE [Take (number of drinks), Annoyed, Cut down, Eye-opener], CAGE (Cut down, Annoyed, Guilt, Eye-opener], NET (Normal drinker, Eye-opener, Tolerance), AUDIT (Alcohol Use Disorder Identification Test), AUDIT-C (AUDIT-consumption) and SMAST (Short Michigan Alcohol Screening Test). Study quality was generally good, but lack of blinding was a common weakness. For risk drinking sensitivity was highest for T-ACE (69-88%), TWEAK (71,91%) and AUDIT-C (95%), with high specificity (71,89%, 73,83% and 85%, respectively). CAGE and SMAST performed poorly. Sensitivity of AUDIT-C at score ,3 was high for past year alcohol dependence (100%) or alcohol use disorder (96%) with moderate specificity (71% each). For life-time alcohol dependency the AUDIT at score ,8 performed poorly. Conclusion T-ACE, TWEAK and AUDIT-C show promise for screening for risk drinking, and AUDIT-C may also be useful for identifying alcohol dependency or abuse. However, their performance as stand-alone tools is uncertain, and further evaluation of questionnaires for prenatal alcohol use is warranted. [source] Validation of the alcohol, smoking and substance involvement screening test (ASSIST)ADDICTION, Issue 6 2008Rachel Humeniuk ABSTRACT Aim The concurrent, construct and discriminative validity of the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were examined in a multi-site international study. Participants One thousand and 47 participants, recruited from drug treatment (n = 350) and primary health care (PHC) settings (n = 697), were administered a battery of instruments. Measurements Measures included the ASSIST; the Addiction Severity Index-Lite (ASI-Lite); the Severity of Dependence Scale (SDS); the MINI International Neuropsychiatric Interview (MINI-Plus); the Rating of Injection Site Condition (RISC); the Drug Abuse Screening Test (DAST); the Alcohol Use Disorders Identification Test (AUDIT); the Revised Fagerstrom Tolerance Questionnaire (RTQ); and the Maudsley Addiction Profile (MAP). Findings Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from the ASI-Lite (r = 0.76,0.88), SDS (r = 0.59), AUDIT (r = 0.82) and RTQ (r = 0.78); and significantly greater ASSIST scores for those with MINI-Plus diagnoses of abuse or dependence (P < 0.001). Construct validity was established by significant correlations between ASSIST scores and measures of risk factors for the development of drug and alcohol problems (r = 0.48,0.76). Discriminative validity was established by the capacity of the ASSIST to discriminate between substance use, abuse and dependence. Receiver operating characteristic (ROC) analysis was used to establish cut-off scores with suitable specificities (50,96%) and sensitivities (54,97%) for most substances. Conclusions The findings demonstrated that the ASSIST is a valid screening test for identifying psychoactive substance use in individuals who use a number of substances and have varying degrees of substance use. [source] Comparison of three models of alcohol craving in young adults: a cross-validationADDICTION, Issue 4 2004Peter M. McEvoy ABSTRACT Aims The aim of study 1 was to develop a three-factor Approach and Avoidance of Alcohol Questionnaire (AAAQ), designed to assess mild and intense inclinations to drink, as well as inclinations to avoid drinking. The aims of study 2 were to cross-validate the AAAQ with an independent sample and to test the goodness-of-fit of three models of craving for alcohol: (a) the traditional unidimensional model; (b) a two-dimensional, approach,avoidance ambivalence model; and (c) an expanded two-dimensional neuroanatomical model that retains avoidance, while positing a threshold that partitions approach into two distinct levels and relates all three factors involved in craving to brain pathways associated with inhibitory processes, reward and obsessive,compulsive behaviour, respectively. Design, setting and participants The survey was administered to 589 Australian university students (69% women) in study 1 and to 523 American university students (64% women) in study 2. Measurements Inclinations to drink and to not drink (AAAQ), drinking behaviour (quantity and frequency), drinking problems (Young Adult Alcohol Problems Screening Test; YAAPST) and readiness for change (Stages of Change Readiness and Treatment Eagerness Scale; SOCRATES). Findings The expanded two-dimensional neuroanatomical model provided the best fit to the data. The AAAQ explained a substantial proportion of the variance in drinking frequency (41,53%), drinking quantity (49,60%) and drinking problems (43%). AAAQ profiles differed as a function of drinking-related risk, and the three AAAQ scales differentially predicted readiness for change. Conclusions Approach and avoidance inclinations toward alcohol are separable constructs, and their activation may not be invariably reciprocal. Craving can be defined as the relative activation of substance-related response inclinations along these two primary dimensions. There may be a threshold of intensity that separates mild from intense approach inclinations. [source] Cognitive dysfunction and health-related quality of life after a cardiac arrest and therapeutic hypothermiaACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2010J. TORGERSEN Background: Evidence-based treatment protocols including therapeutic hypothermia have increased hospital survival to over 50% in unconscious out-of-hospital cardiac arrest survivors. In this study we estimated the incidence of cognitive dysfunctions in a group of cardiac arrest survivors with a high functional outcome treated with therapeutic hypothermia. Secondarily, we assessed the cardiac arrest group's level of cognitive performance in each tested cognitive domain and investigated the relationship between cognitive function and age, time since cardiac arrest and health-related quality of life (HRQOL). Methods: We included 26 patients 13,28 months after a cardiac arrest. All patients were scored using the Cerebral Performance Category scale (CPC) and Mini-Mental State Examination (MMSE). Twenty-five of the patients were tested for cognitive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB). These patients were tested using four cognitive tests: Motor Screening Test, Delayed Matching to Sample, Stockings of Cambridge and Paired Associate Learning from CANTAB. All patients filled in the Short Form-36 for the assessment of HRQOL. Results: Thirteen of 25 (52%) patients were classified as having a cognitive dysfunction. Compared with the reference population, there was no difference in the performance in motor function and delayed memory but there were significant differences in executive function and episodic memory. We found no associations between cognitive function and age, time since cardiac arrest or HRQOL. Conclusion: Half of the patients had a cognitive dysfunction with reduced performance on executive function and episodic memory, indicating frontal and temporal lobe affection, respectively. Reduced performance did not affect HRQOL. [source] The Executive Interview as a Screening Test for Executive Dysfunction in Patients with Mild DementiaJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2005Jette Stokholm MA Objectives: To validate the Executive Interview (EXIT25) as a screening instrument for executive cognitive dysfunction in patients with mild dementia. Design: Validation using group comparison and correlation studies. Setting: The Copenhagen University Hospital Memory Clinic, a multidisciplinary outpatient clinic based in a neurological setting. Participants: Thirty-three patients with mild dementia (MMSE score ,20) and 30 healthy controls. Measurements: The EXIT25, a 25-item screening instrument for executive dysfunction, was administered to all participants. Global cognitive function was measured using the MMSE. Patients were evaluated using traditional neuropsychological tests for executive dysfunction (Wisconsin Card Sorting Test, Trail Making Part B, Stroop Test, verbal fluency, design fluency, and verbal abstraction). Changes in behavior and functional impairment in activities of daily living were assessed using the Frontal Behavioral Inventory (FBI) and the Disability Assessment for Dementia Scale. Results: EXIT25 scores were significantly higher in patients than in the healthy controls; MMSE scores could not account for the differences. Thirteen of the 25 items separated the two groups. EXIT25 was found to correlate significantly with the Stroop Test, the verbal fluency tests, and the FBI. Conclusion: The EXIT25 is able to capture executive cognitive deficits not primarily related to the general level of intellectual reduction in patients with mild dementia. In clinical practice, the EXIT25 might be a valuable supplement to the MMSE. [source] Effects of physical and verbal aggression, depression, and anxiety on drinking behavior of married partners: a prospective and retrospective longitudinal examinationAGGRESSIVE BEHAVIOR, Issue 4 2009Margaret K. Keiley Abstract In an ethnically diverse sample of 195 married couples, we conducted a latent factor growth analysis to investigate the longitudinal link (4 time points over 4½ years) between marital aggression (physical and verbal aggression self- and partner-reports) and individual internalizing symptoms (depression and anxiety) as they relate to trajectories of alcohol use among husbands and wives. Alcohol use was operationalized as a latent factor with self- and partner reports of problem drinking as measured by the Michigan Alcoholism Screening Test and the Alcohol Dependence Scale. Verbal aggression by husbands or wives, by itself, has no effect on their alcohol use over time. In conjunction with depression, however, verbally aggressive husbands do have elevated drinking levels. The effects of husbands' and wives' physical aggression on their own and their partners' drinking behavior were also significant. This study is one of the first to examine the change over time in alcohol use for marital partners as related to marital aggression and internalizing symptoms. Our results shed light on areas of marital functioning (aggression, internalizing, alcohol use) that have not been investigated in conjunction with each other in a longitudinal design. Aggr. Behav. 35:296,312, 2009. © 2009 Wiley-Liss, Inc. [source] Sampling survey on intellectual disability in 0,6-year-old children in ChinaJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 12 2008Z.-H. Xie Abstract Objectives To understand the current status of intellectually disabled children and the prevalence of intellectual disability (ID) in children aged 0,6 years and its risk factors, and to provide scientific evidence to formulate relevant policies for helping intellectually disabled children. Methods Multiphase, stratified, unequal proportional and cluster sampling was adopted to investigate 60 124 children aged 0,6 years. All the children investigated were screened for ID using the Denver Developmental Screening Test, and those with positive screening test would be further diagnosed by varied specialists using the Gesell Developmental Inventory. Results In total, 560 of 60 124 children were diagnosed as intellectually disabled with an overall prevalence of 0.93%. Prevalence of ID was highest in children living in medium-developed areas with a prevalence of 1.20%, higher than in those living in developed areas (0.75%) and in underdeveloped areas (0.84%). It was higher in rural areas (1.03%) than in urban areas (0.83%), and higher in boys (1.01%) than in girls (0.84%). Prevalence of ID increased with the age of children and decreased with the educational level of their parents. Conclusions The study suggested that ID is still prevalent in the children of China, and rehabilitation for them is lagging behind current needs. Early prevention of ID in children and pre-school education for them should be strengthened. [source] Early Risk Indicators of Substance Abuse Among NursesJOURNAL OF NURSING SCHOLARSHIP, Issue 2 2002Margaret Mary West Purpose: To investigate early risk factors that led to substance-related disorders and to predict group differences between substance-impaired (SI) and nonimpaired (NI) registered nurses. Organizing Construct: Donovan's multifactorial model of impairment, and Rogers'Science of Unitary Human Beings. Methods: Data were gathered from 100 previously SI and 100 NI nurses located through use of the Internet. Three questionnaires were used: the Zuckerman Sensation Seeking Scale (ZSSS), the Efinger Alcohol Risk Survey (EARS), and the Children of Alcoholics Screening Test (CAST). Findings: Independent t-test scores showed the two groups differed significantly on all three instruments' total scores. Discriminate analysis indicated a correct prediction of 87% for SI and 95% for NI nurses, with an overall rate of 91%. EARS scores were the best predictor of nurses with substance-related disorders (.99), followed by ZSSS (.44) and CAST (.42) scores. Conclusions: The three variables indicate early risk factors for substance-abuse impairment. Identification of nurses at risk for impairment will allow for earlier intervention and possible prevention. Methods to reduce the number of modifiable risk factors are recommended. [source] Screening for Hazardous Drinking Using the Michigan Alcohol Screening Test,Geriatric Version (MAST-G) in Elderly Persons With Acute Cerebrovascular AccidentsALCOHOLISM, Issue 9 2009Doug Johnson-Greene Background:, Effective and valid screening methods are needed to identify hazardous drinking in elderly persons with new onset acute medical illness. The goal of the current study was to examine the effectiveness of the Michigan Alcohol Screening Test,Geriatric Version (MAST-G) in identifying hazardous drinking among elderly patients with acute cerebrovascular accidents (CVA) and to compare the effectiveness of 2 shorter versions of the MAST-G with the full instrument. Methods:, The study sample included 100 men and women who averaged 12 days posthemorrhagic or ischemic CVA admitted to a rehabilitation unit and who were at least 50 years of age and free of substance use other than alcohol. This cross-sectional validation study compared the 24-item full MAST-G, the 10-item Short MAST-G (SMAST-G), and a 2-item regression analysis derived Mini MAST-G (MMAST-G) to the reference standard of hazardous drinking during the past 3 months. Alcohol use was collected using the Timeline Followback (TLFB). Recent and lifetime alcohol-related consequences were collected using the Short Inventory of Problems (SIP). Results:, Nearly one-third (28%) of the study sample met the World Health Organization (WHO) criteria for hazardous drinking. Moderately strong associations were found for the MAST-G, SMAST-G, and MMAST-G with alcohol quantity and frequency and recent and lifetime alcohol consequences. All 3 MAST-G versions could differentiate hazardous from nonhazardous drinkers and had nearly identical area under the curve characteristics. Comparable sensitivity was found across the 3 MAST-G measures. The optimal screening threshold for hazardous drinking was 5 for the MAST-G, 2 for the SMAST-G, and 1 for the MMAST-G. Conclusions:, The 10-item SMAST-G and 2-item MMAST-G are brief screening tests that show comparable effectiveness in detecting hazardous drinking in elderly patients with acute CVA compared with the full 24-item MAST-G. Implications for research and clinical practice are discussed. [source] Evaluation of a community-based mental health drug and alcohol nurse in the care of people living with HIV/AIDSJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2009J. ALLEN rn ba (hons) m psych (counselling psychology) There is a growing need for advanced practice mental health and drug and alcohol nursing roles in the care of people living with HIV/AIDS; however, limited publications address these domains. This study evaluated a community-based mental health drug and alcohol nurse role caring for people living with HIV/AIDS (Mental Health D&A Nurse) in a large not-for-profit district nursing organization providing care to people living with HIV/AIDS in an Australian city. Outcomes from a client assessment and 6,8-week follow-up by the Mental Health D&A Nurse are presented as captured by the Depression Anxiety Stress Scales (DASS 21), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Health of the Nation Outcome Scales (HONOS) and WHOQoL BREF. Mean scores and caseness were analysed, and significant differences were found on the ,impairment' and ,social problems' subscales of the HONOS. Results of semi-structured interviews with clients describe effective and supportive mental health care and health-promoting education following visits by the Mental Health D&A Nurse. These positive findings support continuing implementation of the role within this community setting and indicate that even greater benefits will ensue as the role develops further. Findings are of interest to clinicians and policy makers seeking to implement similar roles in community-based HIV/AIDS care. [source] A validation of the Dyslexia Adult Screening Test (DAST) in a post-secondary populationJOURNAL OF RESEARCH IN READING, Issue 4 2005Allyson G. Harrison In Ontario, Canada, there is a demand for psychometrically robust screening tools capable of efficiently identifying students with specific learning disabilities (SLD), such as dyslexia. The present study investigated the ability of the Dyslexia Adult Screening Test (DAST) to discriminate between 117 post-secondary students with carefully diagnosed SLDs and 121 comparison students. Results indicated that the DAST correctly identified only 74% of the students with SLDs as ,highly at risk' for dyslexia. Although employing the cutoff for ,mildly at risk' correctly identified 85% of the students with SLDs, this also increased the percentage of students with no major history of learning problems identified as ,at risk' for dyslexia from 16% to 26%. These findings suggest that the DAST in its present form is limited in its ability to screen for SLDs. Implications for future research are discussed. [source] A three-year follow-up study of the psychosocial predictors of delayed and unresolved post-traumatic stress disorder in Taiwan Chi-Chi earthquake survivorsPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2010Chao-Yueh Su MS Aims:, To predict the longitudinal course of post-traumatic stress disorder (PTSD) in survivors three years following a catastrophic earthquake using multivariate data presented six months after the earthquake. Methods:, Trained assistants and psychiatrists used the Disaster-related Psychological Screening Test (DRPST) to interview earthquake survivors 16 years and older and to assess current and incidental psychopathology. A total of 1756 respondents were surveyed over the three-year follow-up period. Results:, A total of 38 (9.1%) of the original 418 PTSD subjects and 40 of the original 1338 (3.0%) non-PTSD subjects were identified as having PTSD at the 3-year post-earthquake follow up. Younger age, significant financial loss, and memory/attention impairment were predictive factors of unresolved PTSD and delayed PTSD. Conclusions:, The longitudinal course of PTSD three years after the earthquake could be predicted as early as six months after the earthquake on the basis of demographic data, PTSD-related factors, and putative factors for PTSD. [source] Clock drawing from the occupational therapy adult perceptual screening test: Its correlation with demographic and clinical factors in the stroke populationAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 3 2010Deirdre M. Cooke Background/aim:,The aim of this study was to explore the relationships between clock drawing ability following stroke, and key clinical variables including cognition, functional independence, side and type of stroke, educational level and age. Methods:,One hundred and ninety-seven people with stroke were recruited from 12 hospital and rehabilitation facilities. The participants' scores from the Clock Drawing Test in the Occupational Therapy Adult Perceptual Screening Test were the dependent variables and were entered into logistic regression with Functional Independence Measure motor scores, side of stroke, Oxfordshire Classification System of Stroke, educational level and age as independent variables. Correlation with the Mini-Mental State Examination was analysed independently, due to its strong correlation with other variables. Results:,The Mini-Mental State Examination correlated significantly with the Clock Drawing Test ( Exp (B) = 0.826, P < 0.001). In the multivariate analysis, a significant relationship was found with age (Exp ( B) = 1.052, P < 0.001), Functional Independence Measure , motor (Exp (B) = 0.984, P = 0.030) and side of stroke (Exp (B) = 0.384, P = 0.003). Age demonstrated the strongest correlation with the Clock Drawing Test ability and the greatest decline was from approximately 70 years of age. Conclusions:,The Clock Drawing Test may be a useful and quick screen of cognitive impairments following stroke. Age-related decline must be considered and it is essential that clinicians use this only as a strategy to determine whether a more comprehensive assessment is required. [source] Alcohol-dependent patients attempting and not attempting suicide: a comparisonACTA NEUROPSYCHIATRICA, Issue 4 2004Özkan Pekta Background:, Alcohol dependence is a psychiatric disorder associated with an increased risk of suicidal behaviour. This is also associated with an increased number of suicide risk factors. Objective:, The current study examined the sociodemographic and clinical characteristics of a number of alcohol-dependent patients who attempted suicide. Methods:, We studied a consecutive series of 377 alcohol-dependent patients in our in-patient clinics. Their alcohol-use histories were assessed through semistructured interviews. The Suicidal Behaviors Questionnaire, the Childhood Trauma Questionnaire, the Michigan Alcoholism Screening Test and the Hamilton Depression Rating Scale were administered to all patients. Serum total cholesterol levels, mean corpuscular volume, the liver enzymes gamma glutamyl transferase, aspartate aminotransferase and alanine aminotransferase were routinely measured. In the statistical analyses, Student's t -test and chi-squared tests were applied. Results:, Of the 377 alcohol-dependent patients, 89 (23.6%) had histories of attempted suicide. Thirty-four (42.5%) of the 80 female alcohol-dependent patients and 55 (18.5%) of the 297 male alcohol-dependent patients had attempted suicide; this gender difference was statistically significant (,2 = 27.7, P < 0.001). A greater proportion of the suicide attempters than of the non-attempters met the Diagnostic Statistical Manual IV criteria for another psychiatric disorder (60.6%, n = 54, vs. 40.6%, n = 117; ,2 = 14.8; df = 6; P < 0.05). The difference of total cholesterol levels between female (mean = 144.0, SD = 58.3; mean = 158.0, SD = 83.9; t = 4.5; P < 0.05) and male (mean = 133.7, SD = 50.5; mean = 163.6, SD = 69.7; t = 11.7; P < 0.01) attempters and non-attempters was statistically significant. Conclusion:, These results suggest that suicide attempts in alcohol-dependent patients are associated with more profound biopsychosocial pathology and decreased serum cholesterol levels. [source] Screening for language delay in the United Arab EmiratesCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2004V. Eapen Abstract Background Developmental language delay (DLD) is frequent among two- and three-year-olds but little is known about this condition in the Arabian Peninsula. This paper forms part of a multipurpose community psychiatric survey conducted in the United Arab Emirates (UAE). The findings regarding the prevalence and psychosocial correlates of DLD are reported here. Methods A total of 694 children, representative of the UAE 3-year-old population were screened using the Denver Developmental Screening Test (DDST) and the language screening procedure as used by Westerlund and Sundelin. Results Of the 694 children screened for DLD at 3 years of age, 69 children (9.9%; CI 7.8,12.4) were found to have delays in the language sector of DDST. A total of 45 (6.5%; CI 4.3,8.7) were identified as having general language disability, both in comprehension and expression as per the language screening procedure. Language delay was found to be associated with rural living, mother being from a different nationality, non-involvement of domestic help in child care, family history of language delay, obstetric and perinatal problems and presence of behavioural problems in the child. Using stepwise multiple logistic regression analysis, two factors emerged as important with regard to general language delay, which were previous non-UAE nationality of the mother and total monthly income of the family. Conclusion The pattern and correlates of DLD found in this survey are in line with those reported by other surveys, but some unique socio-cultural risk factors specific to this community were identified. The implications of these findings to screening and referral for further evaluation and intervention are discussed. [source] Is paediatric assessment of motor development of very preterm and low-birthweight children appropriate?ACTA PAEDIATRICA, Issue 10 2006Martin J. K. DE Kleine Abstract Aim: To determine whether paediatricians that examine, in regular clinical practice, very preterm and very-low-birthweight children at 5 y of age detect neurological impairments and functional motor problems in these children. Methods: We compared a paediatric judgement, a standardized neurological examination (Touwen examination) and a screening of motor development (Denver Developmental Screening Test; DDST) with the Movement ABC in 396 5-y-old very preterm and low-birthweight children. Results: The Movement ABC detected clinically important motor disorders in 20.5% and borderline disturbances in 22.5% of the children. Compared to the Movement ABC, the sensitivity of the paediatric judgement was 0.19, Touwen examination 0.62 and DDST 0.52; the negative predictive values were 0.61, 0.74 and 0.69, respectively. Conclusion: Paediatric assessment of motor development in 5-y-old very preterm and low-birthweight children generally is not sensitive enough to detect functional motor problems. The Movement ABC should be added to the assessment of the motor development of very preterm and low-birthweight children at 5 y of age. [source] Should We Focus on Novel Risk Markers and Screening Tests to Better Predict and Prevent Cardiovascular Disease?PREVENTIVE CARDIOLOGY, Issue 4 2010Or Are We Putting the Cart Before the Horse? No abstract is available for this article. [source] Screening for dyslexia, dyspraxia and Meares-Irlen syndrome in higher educationDYSLEXIA, Issue 1 2009S. A. Nichols Abstract This study reports a comparison of screening tests for dyslexia, dyspraxia and Meares-Irlen (M-I) syndrome in a Higher Education setting, the University of Worcester. Using a sample of 74 volunteer students, we compared the current tutor-delivered battery of 15 subtests with a computerized test, the Lucid Adult Dyslexia Screening test (LADS), and both of these with data on assessment outcomes. The sensitivity of this tutor battery was higher than LADS in predicting dyslexia, dyspraxia or M-I syndrome (91% compared with 66%) and its specificity was lower (79% compared with 90%). Stepwise logistic regression on these tests was used to identify a better performing subset of tests, when combined with a change in practice for M-I syndrome screening. This syndrome itself proved to be a powerful discriminator for dyslexia and/or dyspraxia, and we therefore recommend it as the first stage in a two-stage screening process. The specificity and sensitivity of the new battery, the second part of which comprises LADS plus four of the original tutor delivered subtests, provided the best overall performance: 94% sensitivity and 92% specificity. We anticipate that the new two-part screening process would not take longer to complete. Copyright © 2008 John Wiley & Sons, Ltd. [source] A Screening test for the prediction of Dravet syndrome before one year of ageEPILEPSIA, Issue 4 2008Junri Hattori Summary Purpose: Our aim was to develop a screening test to predict Dravet syndrome before the first birthday based on the clinical characteristics of infants and the SCN1A mutation analysis. Methods: Ninety-six patients who experienced febrile seizures before the age of one were enrolled. The patients were divided into two groups,the Dravet syndrome group (n = 46) and the non-Dravet syndrome group (n = 50). We compared the clinical characteristics before one year of age of the two groups. We analyzed all coding exons of the SCN1A gene by the direct sequencing method. Scores from 0 to 3 were assigned to each risk factor based on the odds ratio and p-value. Results: An age of onset of febrile seizure , 7 months, a total number of seizures , 5, and prolonged seizures lasting more than 10 min. were regarded as significant risk factors for Dravet syndrome. Other factors highly predictive of this syndrome were hemiconvulsions, partial seizures, myoclonic seizures, and hot water,induced seizures. A total clinical score of six or above was the cutoff value indicating a high risk of Dravet syndrome. SCN1A missense and truncated mutations were detected significantly more often in the Dravet syndrome group than in the non-Dravet syndrome group. Discussion: This simple screening test was designed to be used by general pediatricians. It could help to predict Dravet syndrome before one year of age. If the sum of the clinical risk score is , 6, then the performance of an SCN1A mutation analysis is recommended. [source] Long-term complications in survivors of advanced stage neuroblastoma,PEDIATRIC BLOOD & CANCER, Issue 3 2005Caroline Laverdière MD Abstract Background Few studies have assessed late effects in neuroblastoma (NB) survivors, particularly those with advanced stage disease. Methods Retrospective analysis of a cohort of advanced stage NB survivors followed in a late effect clinic at a single institution. Screening tests to detect late effects were tailored depending on the individual's treatment exposures. Results The study included 63 survivors (31 males). The median age at diagnosis was 3.0 years. The median follow-up from diagnosis was 7.06 years. All patients had surgery and received chemotherapy, 89% received radiation therapy (RT), 62% immunotherapy, and 56% autologous stem cell transplant. Late complications were detected in 95% of survivors and included: hearing loss (62%), primary hypothyroidism (24%), ovarian failure (41% of females), musculoskeletal (19%), and pulmonary (19%) abnormalities. The majority of complications were moderate, with only 4% being life-threatening. Survivors who received cisplatin were at greater risk to develop hearing loss compared to those not so treated (OR 9.74; 95% CI: 0.9,101.6). A total dose of cyclophosphamide greater than 7.4 g was associated with ovarian failure (P,=,0.02). Conclusions Late complications occur frequently in survivors of advanced stage NB. The majority of these problems are of mild-moderate severity. Long-term follow-up (LFTU) and screening of this population is essential. © 2005 Wiley-Liss, Inc. [source] Sickle liver disease,An unusual presentation in a compound heterozygote for HbS and a novel ,-thalassemia mutationAMERICAN JOURNAL OF HEMATOLOGY, Issue 9 2007Timothy J.S. Cross A 38-year-old Ghanaian man presented with a 6-month history of worsening pruritus, jaundice, and ascites. He was previously fit and well and rarely drank alcohol. Screening tests for chronic liver disease including viral, autoimmune, and other metabolic causes including iron overload were unremarkable. A liver biopsy performed at the referring hospital demonstrated intralobular cholestasis and cirrhosis. He was listed for liver transplantation but subsequently developed sepsis with multiple organ failure and died. The sickle solubility test was positive. Blood smear showed cells consistent with liver failure and no sickle cells. Hemoglobin electrophoresis revealed HbA2 2.8%, HbF 0.5%, and HbS greater than HbA (49.6% vs. 41.3%) in the absence of blood transfusion. Sequence analysis of the ,IVS2-844 C , A). A diagnosis of sickle hepatopathy causing decompensated cirrhosis was made. This case is unusual insomuch as this patient was asymptomatic for over 35 years and represents a novel presentation of sickle cell disease. Sickle cell disease should be considered in appropriate patients when unusual presentations of liver disease arise. Am. J. Hematol., 2007. © 2007 Wiley-Liss, Inc. [source] Matching health needs of refugee children with services: how big is the gap?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2009Shanti Raman Abstract Objectives: To document the health needs of refugee children accessing comprehensive refugee health services in New South Wales (NSW), to match needs with available services and establish gaps in services. Methods: We collated clinical data on all children aged under 14 years attending the three refugee specific clinics seeing children in NSW in 2005. We compared these data to the number of refugee children settling in NSW in 2005. Results: NSW received 1,557 refugee children (<14 years) in 2005. Around one in five (n=331) was seen in a refugee specific clinic. Most were asymptomatic. Of those tested, 25% had anaemia, 27% were serology positive for schistosomiasis, 16% had evidence of current or recent malaria, 25% were tuberculin skin test positive, 69% were hepatitis B non-immune and 20% had low vitamin D levels. Most children needed catch up immunisation. Other problems included chronic health, developmental and behavioural problems. Screening tests varied across sites. Follow up was problematic for most. Conclusions: A small proportion of refugee children arriving in NSW have access to comprehensive screening and assessment, in spite of significant health needs. There is variation in screening practices, and follow up is poor. There is a high pick up rate for diseases of personal and public health significance. Implications: There is a strong moral and public health imperative to provide appropriately resourced, culturally competent and comprehensive health care to optimise refugee children's wellbeing. [source] Co-ocurrence of developmental delays in a screening study of 4-year-old Finnish childrenDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2004Riitta Valtonen The aim of this population study was to examine the severity and prevalence of co-occurring developmental delays in 4-year-old children, the rate of overlapping problems, and sex differences. A sample of 434 children (196 males, 238 females; mean age 4 years 3 months, SD 1 month) were administered the,Lene'test: a comprehensive neuro-developmental screening test. Results suggest that co-occurrence of attention-behavioural, motor-perceptual, and language delays occurring in school-aged children could already be detected at the age of 4 years. Isolated delays were usually mild, but co-occurring difficulties were mostly moderate or severe. Overlap between developmental delays depended on the severity of the problems. It emerged that males had more severe and more often co-occurring problems than females. Co-occurrence of developmental delays as a risk factor at the early stage of development is discussed. [source] Gestational diabetes: fasting capillary glucose as a screening test in a multi-ethnic, high-risk populationDIABETIC MEDICINE, Issue 8 2009M. M. Agarwal Abstract Aims, In populations at high risk of gestational diabetes mellitus (GDM), screening every pregnant woman by an oral glucose tolerance test (OGTT) is very demanding. The aim of this study was to determine the value of the fasting capillary glucose (FCG) as a screening test for GDM. Methods, FCG was measured by a plasma-correlated glucometer in 1465 pregnant women who underwent a one-step diagnostic 75-g OGTT for universal screening of GDM. Results, One hundred and ninety-six (13.4%) women had GDM as defined by the criteria of the American Diabetes Association. The area under the receiver operating characteristic curve (AUC) of the FCG was 0.83 (95% confidence interval 0.80,0.86). A FCG threshold of 4.7 mmol/l (at an acceptable sensitivity of 86.0%) independently could rule-out GDM in 731 (49.9%) women, while the FCG could rule-in GDM (100% specificity) in 16 (1.1%) additional women; therefore, approximately half of the women would not need to continue with the cumbersome OGTT. Conclusions, Screening using a FCG significantly reduces the number of OGTTs needed for the diagnosis of GDM. Wider assessment, particularly in low-risk populations, would confirm the potential value of the FCG as a screening test for GDM. [source] The value of the Rydel-Seiffer tuning fork as a predictor of diabetic polyneuropathy compared with a neurothesiometerDIABETIC MEDICINE, Issue 6 2004T. Kästenbauer Abstract Aims The aim of the study was to investigate the predictive value of the Rydel-Seiffer tuning fork for detecting diabetic neuropathy and to compare it with an electronic neurothesiometer. Methods In 2022 consecutive diabetic subjects, peripheral polyneuropathy was diagnosed by vibration perception threshold (VPT) at the tip of both great toes using a 128-Hz tuning fork and a neurothesiometer, by simple bedside tests and by the presence of neuropathic symptoms. These evaluations were further combined to diagnose peripheral nerve dysfunction (abnormal bedside tests) and symptomatic neuropathy. VPT was also measured in 175 non-diabetic control subjects to define normal values. Results VPT was normal in 1917 subjects and abnormal in 105 (5.2%) patients when measured by the tuning fork. Patients with an abnormal vibration test were significantly (P < 0.0001) older than subjects with a normal vibration sense, while diabetes duration and HbA1c of the former were also significantly elevated. The same was true for the percentages of an abnormal 10-g monofilament test (66.7% vs. 7.2%, P < 0.0001) and a missing Achilles' tendon reflex (68.6% vs. 24.8%, P < 0.0001). Finally, the VPT measured by the neurothesiometer was 2.5 times higher in patients with an abnormal tuning fork test (32.0 ± 9.8 vs. 12.5 ± 6.4 V, P < 0.0001). The plot of the difference of both methods against their mean yielded a good agreement of the two VPT measurements, and the tuning fork had a high sensitivity and positive predictive value for the diagnosis of abnormal bedside tests and for symptomatic neuropathy. Conclusion The tuning fork reliably detected peripheral neuropathy in comparison with the neurothesiometer. A tuning fork is a useful screening test for diabetic neuropathy. [source] Validation of the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): report of results from the Australian siteDRUG AND ALCOHOL REVIEW, Issue 3 2005DAVID A. L. NEWCOMBE Abstract The concurrent, construct, discriminative and predictive validity of the World Health Organization's Alcohol Substance Involvement Screening Test (ASSIST) were examined in an Australian sample. One hundred and fifty participants, recruited from drug treatment (n = 50) and primary health care (PHC) settings (n = 100), were administered a battery of instruments at baseline and a modified battery at 3 months. Measures included the ASSIST; the Addiction Severity Index-Lite (ASI-Lite); the Severity of Dependence Scale (SDS); the MINI International Neuropsychiatric Interview (MINI-Plus); the Rating of Injection Site Condition (RISC); the Drug Abuse Screening Test (DAST); the Alcohol Use Disorders Identification Test (AUDIT); the Revised Fagerstrom Tolerance Questionnaire (RTQ); and the Maudsely Addiction Profile (MAP). Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from the ASI-lite, SDS, AUDIT and DAST; and significantly greater ASSIST scores for those with diagnoses of abuse or dependence. Construct validity was established by significant correlations between ASSIST scores and measures of risk factors for the development of drug and alcohol problems. Participants diagnosed with attention deficit/hyperactivity disorder or antisocial personality disorder had significantly higher ASSIST scores than those not diagnosed as such. Discriminative validity was established by the capacity of the ASSIST to discriminate between substance use, abuse and dependence. ROC analysis was able to establish cut-off scores for an Australian sample, with suitable specificities and sensitivities for most substances. Predictive validity was demonstrated by similarity in ASSIST scores obtained at baseline and at follow-up. The findings demonstrated that the ASSIST is a valid screening test for psychoactive substance use in individuals who use a number of substances and have varying degrees of substance use. [source] | ||||||||||||||||||||||||||||||||||||||||||||||